Tubulointerstitial nephritis and uveitis syndrome: A case series
The tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) affects adolescent females preferentially, and it is typically
characterized by the association of tubulointerstitial nephritis and anterior bilateral uveitis. However, it may have different atypical
presentations. It can be seen in male, in adults, without renal insufficiency, or with a posterior uveitis. We report three cases of
atypical TINU syndrome. We reported two out of three adult patients (16, 60, and 62 years of age), two of whom were female and
one male. The first patient had a panuvéitis of the left eye and a posterior uveitis of the right eye. The second patient presented
bilateral panuveitis with retinal vasculitis. The third patient had a bilateral anterior uveitis recurrent. The three patients had
proteinuria, glucosuria, aseptic leukocyturia without renal insufficiency. Renal biopsy showed tubulointerstitial nephritis with
no sign of vasculitis or glomerular involvement. The etiological investigation did not find any cause (infection, medication, and
systemic illness). The patients received a local and general corticosteroid therapy associated in one case with methotrexate, which
has resulted in rapid improvement for all three patients. This clinical case report highlights some important features of TINU
syndrome, including the increasing incidence of disease in male and adult patients, the possibility of a posterior involvement of
uveitis, and clinical presentation without kidney failure. Extensive studies are needed to elucidate the cause and pathogenesis of
this syndrome for better management.
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