title: Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations.
abstract: We here describe three different clinical manifestations of tubulointerstitial nephritis and uveitis (TINU) syndrome. We examined and diagnosed the following 3 patients: a 15-year-old boy with bilateral anterior uveitis (Case 1), a 14-year-old girl with bilateral papilledema (Case 2), and a 49-year-old woman with panuveitis (Case 3). The findings are presented herein. Case 1: The patient had bilateral anterior uveitis. Urinalysis revealed markedly increased β2-microglobulin and N-acetyl-β-D-glucosaminidase levels. As the patient was pathologically diagnosed with tubulointerstitial nephritis (TIN), we diagnosed TINU based on the presence of both uveitis and TIN. He was treated with oral corticosteroids. Case 2: This patient showed anterior uveitis and papilledema in both eyes. On initial examination, the urine test results did not show any abnormality. Three months later, high β2-microglobulin and N-acetyl-β-D-glucosaminidase levels were detected. As the patient was clinically diagnosed with TIN, we subsequently diagnosed TINU. Both the ocular and renal findings improved without treatment. Case 3: The patient developed bilateral panuveitis, retinal vasculitis, and macular edema, which were initially suspected to be sarcoidosis. However, she was pathologically diagnosed with TIN 12 months before the onset of uveitis; therefore, she was finally diagnosed with TINU. She recovered with local corticosteroid administration only. TINU may present with fundal features in addition to anterior uveitis. Detailed history taking and urinalysis are important to determine the presence of tubular disorders in similar patients.
authors: Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan. howdoyoulikechosan1027@gmail.com.
authors: Takamitsu
authors: T
authors: Nagashima
authors: Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan.
authors: Mami
authors: M
authors: Ishihara
authors: Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan.
authors: Etsuko
authors: E
authors: Shibuya
authors: Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan.
authors: Satoshi
authors: S
authors: Nakamura
authors: Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan.
authors: Nobuhisa
authors: N
authors: Mizuki
mesh_terms: D000293:Adolescent; D001706:Biopsy; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000175:diagnosis* / Q000188:drug therapy; D009898:Optic Disk / Q000473:pathology; D013577:Syndrome; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D005938:Glucocorticoids
keywords: Tubulointerstitial nephritis; Urinalysis; Urine N-acetyl-β-D-glucosaminidase; Urine β2-microglobulin; Uveitis