Korean J Ophthalmol.  2012 Oct;26(5):398-401. 10.3341/kjo.2012.26.5.398.

A Case of Tubulointerstitial Nephritis and Uveitis Syndrome in an Elderly Patient

• Han JM
• Lee YJ
• Woo SJ

• KMID: 1397494
• DOI: http://doi.org/10.3341/kjo.2012.26.5.398

Abstract

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease entity usually occurring in children. In the present study a case of TINU syndrome in an elderly patient is described and relevant literature is reviewed. A 61-year-old man presented with bilateral flank pain, urinary frequency, and foamy urine. A kidney ultrasonography revealed an increase in kidney parenchyma echogenicity. Following a kidney biopsy, the patient was diagnosed with acute tubulointerstitial nephritis. An ophthalmology examination initially performed for floater symptoms, revealed anterior uveitis in both eyes. Acute tubulointerstitial nephritis and anterior uveitis in both eyes responded to treatment with oral prednisolone, furosemide, carvedilol, and a topical steroid. TINU syndrome can occur in the elderly and should be part of the differential diagnosis when seeing a patient who has uveitis in association with renal disease; any therapy should be managed by both an internist and an ophthalmologist.

Keyword

Interstitial nephritis; Nephritis; Renal diseases; Tubulointerstitial nephritis and uveitis; Uveitis

MeSH Terms

Biopsy
Diagnosis, Differential
Glucocorticoids/therapeutic use
Humans
Male
Middle Aged
Nephritis, Interstitial/*diagnosis/drug therapy
Uveitis/*diagnosis/drug therapy

Figure

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  Fig. 1 Light microscopic view of kidney biopsy specimen (H&E, ×400). The infiltration of eosinophils and plasma cells was observed (arrow), while the glomerulus was relatively spared (arrowhead).

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  Fig. 2 Electron microscopic view of kidney biopsy specimen (×3,000). There were no electron-dense deposits.

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