Doença autoimune que compreende nefrite tubulointersticial e uveíte.
Introdução
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Doença autoimune que compreende nefrite tubulointersticial e uveíte.
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<1/50kMuito rara
1/20kRara
1/10kPouco freq.
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Publicações mais relevantes
Clinical Features and Treatment Outcomes of Patients with Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
Describe the demographic and clinical characteristics, treatment outcomes, and ocular complications in patients with tubulointerstitial nephritis and uveitis (TINU) syndrome. Retrospective study of TINU patients seen at the Foster Center for Ocular Immunology (Duke University) and Wilmer Eye Institute (Johns Hopkins School of Medicine) between January 2014-December 2023. Patients were diagnosed using the 2021 SUN Working Group criteria. 27 TINU patients, 16 (59%) males, aged 20.4 ± 15.8 (range: 7-71) years were included. The mean follow-up time was 24.3 ± 16.5 (range: 7-75) months. All tested patients had an elevated urinary β2-microglobulin. Ten (37%) patients had positive renal biopsy. Thirteen (48%) patients presented with isolated anterior uveitis, and 14 (52%) had additional intermediate/posterior segment findings in at least one eye. At baseline, all patients were managed with topical corticosteroids (TCS), with 6 (27%) patients requiring oral prednisone (PRD) and 17 (63%) steroid-sparing immunosuppressive therapy (SS-IMT). Inflammatory control was achieved in 26 (96%) patients with TCS only (n = 4), TCS+PRD (n = 5), TCS+SS-IMT (n = 6), and TCS+PRD+SS-IMT (n = 11). Thirteen of 26 patients (50%) developed disease relapse at a mean time of 8.9 ± 18.9 (range: 1-71) months. One patient was lost to follow-up. Eighteen (67%) patients developed TINU-associated ocular complications. Five eyes from 4 patients had a median decrease in visual acuity of 2 Snellen lines (range: 1-4) during follow-up. The demographic and clinical presentation of TINU is heterogeneous. Intermediate and posterior segment manifestations are common. Treatment with topical and systemic corticosteroids only may be insufficient to prevent disease relapse, with most patients requiring long-term immunosuppressive therapy.
Clinical Presentation and Management of Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare systemic inflammatory condition characterized by oculorenal involvement. The pathophysiology is not fully understood but is thought to involve an immune-mediated response, potentially triggered by infections, medications, or genetic factors. TINU syndrome is often challenging to diagnose due to the asynchronous presentation of ocular and renal manifestations, requiring the exclusion of other systemic diseases. We present a four-case series of TINU syndrome, diagnosed between 2014 and 2024 at a tertiary center, highlighting the diversity in clinical presentations and outcomes, with the aim of bringing the authors' experience in the diagnosis and management of this still underrecognized syndrome.
Tubulointerstitial nephritis and uveitis syndrome: an unexpected diagnosis.
A male in his 50s presented to the renal department with a diagnostic challenge of an unexplained kidney injury. Antiphospholipid antibody syndrome and oral anticoagulation augmented the risk for a renal biopsy. This, along with relatively static estimates of glomerular filtration rate combined to delay renal biopsy and definitive renal diagnosis by 6 months. The late emergence of symptomatic bilateral anterior uveitis consolidated the diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome but it also highlighted a lack of systemic early screening for ocular disease in the renal clinic. When faced with a diagnostic challenge, clinicians are more likely to find clinical conditions they are actually looking for. Increased awareness of TINU, earlier screening for ocular symptoms at presentation and/or examination for asymptomatic uveitis when a diagnosis of tubulointerstitial nephritis is being considered is recommended. Furthermore, early screening in cases of bilateral anterior uveitis for existing kidney issues should be pursued.
Tubulointerstitial nephritis and uveitis syndrome in children: What to keep an eye on.
The purpose of this study was to determine the disease course in patients with tubulointerstitial nephritis and uveitis (TINU) syndrome, focusing on long-term outcome and the incidence of complications such as chronic kidney disease (CKD). We retrospectively analysed the recorded clinical characteristics of 32 children with TINU at their first presentation (baseline) and during a follow-up period of up to 27 months (range: 21-27 months). The majority of patients (27/32; 84.4%) presented initially with ophthalmological symptoms. The most common initial ophthalmological presentation was anterior unilateral or bilateral uveitis, which in 23 patients progressed to chronic bilateral panuveitis. Patients who presented initially to their paediatrician with nephritis developed ocular symptoms within 4 months following the onset of nephritis. Inflammatory markers of active tubulointerstitial nephritis resolved more quickly than markers of active uveitis (p-value = 0.001). At 21-27 months, 7/23 patients (30.4%) had chronic kidney disease (CKD); moreover, these patients with CKD were significantly less likely to have received systemic corticosteroids at the onset of TINU compared to those without CKD (p-value = 0.045). Due to its heterogeneity in clinical presentation, all paediatric patients presenting with unilateral or bilateral uveitis should be screened for TINU. Likewise, patients who present with tubulointerstitial nephritis should be screened for the development of uveitis within the first several months. Ophthalmological outcome is favourable after long-term treatment with immunosuppressive medications. Finally, identifying tubulointerstitial nephritis early is important, as nearly one-third of cases can develop CKD and may therefore benefit from early treatment with corticosteroids.
Adalimumab in refractory pediatric tubulointerstitial nephritis and uveitis syndrome: a case report of sustained renal-ocular remission and literature review.
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease characterized by idiopathic acute tubulointerstitial nephritis and uveitis. To date, there are no standard therapeutic protocols. The renal damage may be clinically severe and persistent, and the uveitis tends to recur or progress to a chronic state, posing significant treatment challenges. We present a pediatric case of refractory TINU syndrome successfully treated with adalimumab, which provide a reference for its management. A 7-year-old boy initially presented with mild proteinuria and acute kidney injury, accompanied by a reduced estimated glomerular filtration rate (eGFR) of 57.5 mL/min/1.73 m². A kidney biopsy revealed acute tubulointerstitial nephritis. He was treated with oral prednisolone, with partial improvement of kidney function. Three months after the first symptoms, bilateral anterior uveitis developed, establishing the diagnosis of TINU syndrome. Treatment initially involved systemic glucocorticoids combined with mycophenolate mofetil, but the uveitis persisted with recurrent episodes refractory to treatment. The patient received a 10-month course of adalimumab, a monoclonal antibody targeting Tumor necrosis factor-α (TNF-α). There was a significant resolution of ocular inflammation and normalization of kidney function, with a restored eGFR of 101.05 mL/min/1.73 m². Throughout the 1.25-year follow-up, no adverse events (including infections) occurred, and no recurrence was observed. Adalimumab can effectively control inflammatory responses and reduce recurrence in pediatric TINU syndrome, with a favorable safety profile, thereby providing a novel and promising biologic alternative for steroid-resistant or refractory cases. It is recommended to focus on ocular lesions in patients with tubulointerstitial injuries to avoid missing the diagnosis of TINU syndrome.
Publicações recentes
Age-Related Differences in the Etiology and Clinical Characteristics of Uveitis in Japan: A Retrospective Comparative Study.
Clinical Features and Treatment Outcomes of Patients with Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
Clinical Presentation and Management of Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
Tubulointerstitial nephritis and uveitis syndrome: an unexpected diagnosis.
Tubulointerstitial nephritis and uveitis syndrome in children: What to keep an eye on.
📚 EuropePMC146 artigos no totalmostrando 100
Clinical Features and Treatment Outcomes of Patients with Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
Ocular immunology and inflammationClinical Presentation and Management of Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
CureusTubulointerstitial nephritis and uveitis syndrome: an unexpected diagnosis.
BMJ case reportsTubulointerstitial nephritis and uveitis syndrome in children: What to keep an eye on.
Acta ophthalmologicaAdalimumab in refractory pediatric tubulointerstitial nephritis and uveitis syndrome: a case report of sustained renal-ocular remission and literature review.
BMC nephrologyFatigue, Polyuria, and Hidden Uveitis: A Case of Tubulointerstitial Nephritis and Uveitis Syndrome Diagnosed in Primary Care.
CureusA rare concurrence of monoclonal gammopathies in an older adult with tubulointerstitial nephritis and uveitis syndrome.
BMC geriatricsDrug-induced tubulointerstitial nephritis and uveitis syndrome in a nationwide surveillance.
Eye (London, England)Autoimmune Tubulopathies.
Journal of the American Society of Nephrology : JASNTubulointerstitial Nephritis and Uveitis Syndrome Presenting with Scleritis.
Ocular immunology and inflammationAdalimumab to treat noninfectious pediatric chronic anterior uveitis: a case series.
International ophthalmologyTubulointerstitial Nephritis and Uveitis in a Pediatric Patient.
CureusTubulointerstitial Nephritis and Uveitis Syndrome: A Case Report.
CureusClinical outcomes in paediatric tubulointerstitial nephritis and uveitis syndrome (TINU).
Eye (London, England)Acute neuroretinitis as a delayed manifestation of tubulointerstitial nephritis and uveitis syndrome.
American journal of ophthalmology case reportsTubulointerstitial Nephritis and Uveitis: A Case Report.
CureusTubulointerstitial Nephritis and Uveitis Syndrome During the COVID-19 Pandemic: A Case Series.
Turkish journal of ophthalmologyAssociation between Tubulointerstitial Nephritis and Uveitis Syndrome and Small-Vessel CNS Vasculitis: A Case of Polyautoimmunity.
NeuropediatricsA different presentation of tubulointerstitial nephritis and uveitis syndrome mimicking Sjögren's syndrome.
Archives of rheumatologyTubulointerstitial Nephritis and Uveitis Syndrome in Pediatric Patients.
Ocular immunology and inflammationA case of tubulointerstitial nephritis and uveitis syndrome accompanied by subclinical choroiditis.
BMC ophthalmologyClinical manifestations and outcomes in tubulointerstitial nephritis and uveitis syndrome: a case report and a systematic review in China.
International urology and nephrologyAtypical Presentation of Tubulointerstitial Nephritis and Uveitis Syndrome, a Rare Disease.
Journal of vitreoretinal diseasesDiagnostic and Management Strategies of Tubulointerstitial Nephritis and Uveitis Syndrome (TINU): Current Perspectives.
Clinical ophthalmology (Auckland, N.Z.)Diagnosis and Characteristics of Presentation of Tubulointerstitial Nephritis and Uveitis Syndrome During the COVID-2019 Pandemic.
Ocular immunology and inflammationOcular manifestations and clinical outcomes in Tubulointerstitial Nephritis and Uveitis Syndrome (TINU).
Eye (London, England)Tubulointerstitial Nephritis and Uveitis Syndrome: A Report of 6 Cases with Renal Biopsy and Electron Microscopy Evaluation.
NephronTubulointerstitial nephritis and uveitis syndrome (TINU) following COVID-19 vaccination.
American journal of ophthalmology case reportsTubulointerstitial nephritis and uveitis syndrome and SARS-CoV-2 infection in an adolescent: just a coincidence in time?
Pediatric nephrology (Berlin, Germany)Tubulointerstitial nephritis and uveitis syndrome post-COVID-19.
Pediatric investigationChanging face of non-infectious pediatric uveitis in the pre-pandemic and pandemic periods: a comparison study.
Postgraduate medicineTubulointerstitial Nephritis and Uveitis Syndrome in the United Arab Emirates.
Ocular immunology and inflammationGenome-Wide Association Study in Acute Tubulointerstitial Nephritis.
Journal of the American Society of Nephrology : JASNTubulointerstitial Nephritis and Uveitis Syndrome (TINU) after Intake of Dietary Supplement.
Ocular immunology and inflammationRARE COMPLICATION OF COVID -19 DISEASE TINU SYNDROME IN A 11-YEAR-OLD BOY, FEATURES AND MANAGMENT.
Wiadomosci lekarskie (Warsaw, Poland : 1960)Renal outcomes in tubulointerstitial nephritis and uveitis (TINU) syndrome: a systematic review and meta-analysis.
Journal of nephrologyTubulointerstitial Nephritis and Uveitis Syndrome (TINU): A Case Series in a Tertiary Care Uveitis Setting.
Journal of clinical medicineClinical management of a granulomatous tubulointerstitial nephritis associated with a bilateral granulomatous anterior uveitis: A challenging case report and review of the literature.
Clinical nephrologyA case of tubulointerstitial nephritis and uveitis syndrome following drug-induced acute interstitial nephritis.
Clinical case reports[Tubulointerstitial nephritis and uveitis syndrome].
Ugeskrift for laegerA non-immunocompromised host with nontuberculous mycobacteria-associated tubulointerstitial nephritis.
CEN case reportsClinical Features and Outcomes of Tubulointerstitial Nephritis and Uveitis Syndrome in Spain and Portugal: The IBERTINU Project.
Ocular immunology and inflammationRenal replacement therapy-requiring acute kidney injury due to tubulointerstitial nephritis and uveitis syndrome: case report.
Journal of medical case reportsMultimodal imaging in pediatric uveitis.
Therapeutic advances in ophthalmologyRenal Prognosis in Children With Tubulointerstitial Nephritis and Uveitis Syndrome.
Kidney international reportsCharacteristics of renal sarcoidosis and tubulointerstitial nephritis and uveitis syndrome in Slovenia: An analysis of the national renal biopsy registry and patient datasets in the last decade.
Clinical nephrologyImmunomodulation and TNF-α inhibition for tubulointerstitial nephritis and uveitis syndrome: a case series.
Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and StrabismusTubulointerstitial nephritis and uveitis syndrome following meningitis and systemic lymphadenopathy with persistent Toxoplasma immunoglobulin M: a case report.
Journal of medical case reportsTubulointerstitial nephritis and uveitis syndrome in an adolescent female: a case report.
Journal of medical case reportsSubclinical Choroidal Inflammation Revealed by Indocyanine Green Angiography in Tubulointerstitial Nephritis and Uveitis Syndrome.
Ocular immunology and inflammationTubulointerstitial Nephritis and Uveitis Syndrome: Case Series and Literature Review.
Case reports in ophthalmological medicineAetiology, course and treatment of acute tubulointerstitial nephritis in paediatric patients: a cross-sectional web-based survey.
BMJ openRecurrent acute interstitial nephritis: what lies beneath.
Clinical kidney journalTubulointerstitial nephritis and uveitis syndrome: a systematic review.
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal AssociationLong-term clinical characteristics and renal prognosis of children with tubulointerstitial nephritis and uveitis syndrome.
Pediatric nephrology (Berlin, Germany)An Unusual Association: Takayasu's Arteritis and Tubulointerstitial Nephritis and Uveitis Syndrome.
European journal of case reports in internal medicineTubulointerstitial nephritis and uveitis syndrome with concurrent macular edema caused by granulomatous uveitis.
Clinical case reportsTubulointerstitial nephritis and uveitis: The first report from the ophthalmology perspective in India.
Indian journal of ophthalmologyTubulointerstitial nephritis and uveitis syndrome: Our experience.
Oman journal of ophthalmologyTubulointerstitial Nephritis and Uveitis Syndrome: Characterization of Clinical Features.
Ocular immunology and inflammationA case of adult-onset tubulointerstitial nephritis and uveitis syndrome presenting with granulomatous panuveitis.
Taiwan journal of ophthalmologyClinical Features and Visual Outcome of Uveitis in Japanese Patients Younger than 18 Years.
Ocular immunology and inflammationAcute tubulointerstitial nephritis in children- a retrospective case series in a UK tertiary paediatric centre.
BMC nephrologyCo-occurrence of bilateral nodular anterior scleritis and large-vessel arteritis in a patient with TINU syndrome.
GMS ophthalmology casesUltra-widefield Fluorescein Angiography and OCT Findings in Tubulointerstitial Nephritis and Uveitis Syndrome.
Ophthalmology. RetinaBilateral decompression retinopathy after deep sclerectomy with mitomycin C in a child with tubulointerstitial nephritis and uveitis syndrome.
European journal of ophthalmologyReal-world evidence of treatment for relapse of noninfectious uveitis in tertiary centers in Japan: A multicenter study.
MedicineTubulointerstitial nephritis and uveitis syndrome in a female adult.
BMJ case reportsUrinary β2-microglobulin and disease activity in patients with tubulointerstitial nephritis and uveitis syndrome.
Journal of ophthalmic inflammation and infectionTubulointerstitial Nephritis and Uveitis Syndrome with unilateral enthesopathy of the knee joint.
RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der NuklearmedizinTubulointerstitial nephritis and uveitis syndrome in children: report of three cases.
Jornal brasileiro de nefrologiaClinical and Genetic Features of Tubulointerstitial Nephritis and Uveitis Syndrome with Long-Term Follow-Up.
Journal of ophthalmologyMeasurement of urinary biomarkers in a case of tubulointerstitial nephritis and uveitis syndrome during glucocorticoid treatment.
CEN case reportsTubulointerstitial nephritis and uveitis (TINU) with granulomatosis: a novel report of simultaneous TINU and sarcoidosis in a pediatric patient.
Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and StrabismusA child with tubulointerstitial nephritis and uveitis (TINU) syndrome.
BMJ case reportsClinical Profile, Ultra-Wide-Field Fluorescence Angiography Findings, and Long-Term Prognosis of Uveitis in Tubulointerstitial Nephritis and Uveitis Syndrome at One Tertiary Medical Institute in China.
Ocular immunology and inflammationEtiology and renal outcomes of acute tubulointerstitial nephritis: a single-center prospective cohort study in China.
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal AssociationFOXP3+ T cells are present in kidney biopsy samples in children with tubulointerstitial nephritis and uveitis syndrome.
Pediatric nephrology (Berlin, Germany)Tubulointerstitial nephritis and uveitis (TINU) syndrome: a systematic review of its epidemiology, demographics and risk factors.
Orphanet journal of rare diseasesTubulointerstitial nephritis and uveitis syndrome (TINU). Treatment with immunosuppressive therapy.
Archivos de la Sociedad Espanola de OftalmologiaAcute tubulointerstitial nephritis and uveitis syndrome: A report on four adult cases.
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia[Tubulointerstitial nephritis syndrome and uveitis].
MedicinaLong-term Follow-up of Patients with Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome.
Ocular immunology and inflammationA Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach.
The American journal of case reportsThree cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations.
International ophthalmologySynthetic Cannabinoid Induced acute Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Report and Review of Literature.
Journal of clinical and diagnostic research : JCDRClinicopathologic characteristics, treatment, and outcomes of tubulointerstitial nephritis and uveitis syndrome in adults: A national retrospective strobe-compliant study.
MedicineRecurrence of Tubulointerstitial Nephritis Without Uveitis, in a Patient with Previous Tubulointerstitial Nephritis and Uveitis Syndrome After Transplant.
Experimental and clinical transplantation : official journal of the Middle East Society for Organ TransplantationTubulointerstitial Nephritis and Uveitis Syndrome Associated With Human Papillomavirus Vaccine.
Journal of pediatric ophthalmology and strabismusTINU syndrome: review of the literature and case report.
Jornal brasileiro de nefrologiaTubulointerstitial Nephritis and Uveitis Syndrome: Are Drugs Offenders or Bystanders?
Clinical medicine insights. Case reportsTUBULOINTERSTITIAL NEPHRITIS AND UVEITIS SYNDROME WITH A PRIMARY PRESENTATION OF ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY.
Retinal cases & brief reportsDobrin syndrome: A case report and review of the literature.
Indian journal of nephrology[Tubulointerstitial nephritis and uveitis – case report].
Klinika ocznaTubulointerstitial Nephritis and Uveitis Syndrome in an Elderly Man: Case Report and Literature Review.
MedicineChoroidal neovascularization secondary to tubulointerstitial nephritis and uveitis syndrome (TINU) in an adult patient.
Journal of ophthalmic inflammation and infectionTubulointerstitial Nephritis and Uveitis Syndrome: Case Report and Review of the Literature.
Ocular immunology and inflammationUrinary β2-Microglobulin Testing in Pediatric Uveitis: A Case Report of a 9-Year-Old Boy with Renal and Ocular Sarcoidosis.
Case reports in ophthalmologyAcute granulomatous iridocyclitis in a child with tubulointerstitial nephritis and uveitis syndrome.
Journal of ophthalmic inflammation and infectionTubulointerstitial nephritis and uveitis syndrome in an elderly woman.
Clinical kidney journalAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Clinical Features and Treatment Outcomes of Patients with Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
- Clinical Presentation and Management of Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Series.
- Tubulointerstitial nephritis and uveitis syndrome: an unexpected diagnosis.
- Tubulointerstitial nephritis and uveitis syndrome in children: What to keep an eye on.
- Adalimumab in refractory pediatric tubulointerstitial nephritis and uveitis syndrome: a case report of sustained renal-ocular remission and literature review.
- Age-Related Differences in the Etiology and Clinical Characteristics of Uveitis in Japan: A Retrospective Comparative Study.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:91500(Orphanet)
- OMIM OMIM:607665(OMIM)
- MONDO:0011885(MONDO)
- GARD:9252(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q3961624(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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