ESPN 50th Annual Meeting

ESPN 2017


 
Tubulointerstitial nephritis and uveitis (TINU) syndrome in a 6 year-old male patient
Özge Nur Aktaş 1 Mehmet Taşdemir 2 Halil Gümüş 3 Ilmay Bilge 4

1- Koç University School Of Medicine, Istanbul, Turkey
2- Koç University Hospital, Department of Pediatrics, Division of Pediatric Nephrology, Istanbul, Turkey
3- Private Practice, Bursa, Turkey
4- Koç University School of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Istanbul, Turkey
 
Introduction:

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare condition which has a combination of ocular inflammation and renal interstitial and tubular inflammation. Less than 300 cases have been reported since 1975, first description of the syndrome. Etiology of this syndrome is poorly understood, though immunologic processes are thought to play a role.

Material and methods:

Case presentation

 

Results:

Six year 2 month-old boy presented with red eyes and blurry vision. There was a history of fever, poor apetite, fatigue one, amoxicillin and nonsteroidal anti-inflammatory drug use a month ago. Patient was referred to our clinic with suspicion of acute kidney injury. Blood urea nitrogen (BUN) and serum creatinine (Cr) levels were increased (23.3 and 2.4 mg/dL, respectively). Tru-cut renal biopsy was performed, and IV pulse methylprednisolone treatment was administered. Lymphocyte predominant leukocytic infiltration, tubulitis, hydrophic degeneration and necrosis in tubule epithelium was reported in the biopsy specimen, confirming the definitive diagnosis of TINU. Oral methylprednisolone treatment has been continued for a month and gradual decline in both BUN and Cr was documented.

Conclusions:

Any patient presenting with uveitis should be considered more carefully not to miss underlying TINU syndrome. Renal biochemical parameters including urinary beta-2 microglobulin could be useful to assess any renal abnormality in patients with uveitis which can be a hint for TINU syndrome.