title: Adult-onset acute tubulointerstitial nephritis and uveitis with Fanconi syndrome. Case report and review of the literature.
abstract: We report a case of tubulointerstitial nephritis and uveitis (TINU syndrome) with full type Fanconi syndrome. A 32-year-old woman presented with fatigue, anorexia and weight loss. Laboratory findings showed anemia, polyclonal hypergammaglobulinemia and moderate renal dysfunction. Tubular function abnormalities were normoglycemic glucosuria, panaminoaciduria, phosphaturia and kaliuresis leading to hypokalemia. Renal tubular acidosis and hypouricemia were also evident. Serum antistreptolysin O titer was high. Ocular symptoms (bilateral anterior uveitis) emerged soon after admission. Renal biopsy showed diffuse tubulointerstitial infiltration by lymphocytes and plasma cells without granuloma. Treatment with systemic steroids was given and renal function, and ocular symptom returned to normal with 3 months. Although tubular abnormalities involving TINU syndrome has already been reported, the disease associated with full type Fanconi syndrome has rarely been seen, and systemic steroid may be beneficial in reducing the development of tubulointerstitial injury.
authors.affiliation: Department of Medicine, Division of Nephrology, Kurume University School of Medicine, Kurume, Japan. koike_kiyomi@kurume-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Koike
authors.forename: S
authors.initials: S
authors.lastname: Lida
authors.forename: M
authors.initials: M
authors.lastname: Usui
authors.forename: Y
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: K
authors.initials: K
authors.lastname: Fukami
authors.forename: S
authors.initials: S
authors.lastname: Ueda
authors.forename: K
authors.initials: K
authors.lastname: Tamaki
authors.forename: S
authors.initials: S
authors.lastname: Kato
authors.forename: S
authors.initials: S
authors.lastname: Okuda
mesh_terms: D000208:Acute Disease; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005198:Fanconi Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D009395:Nephritis, Interstitial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D014605:Uveitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone