Tubulointerstitial nephritis and uveitis syndrome: A case series

The tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) affects adolescent females preferentially, and it is typicallycharacterized by the association of tubulointerstitial nephritis and anterior bilateral uveitis. However, it may have different atypicalpresentations. It can be seen in male, in adults, without renal insufficiency, or with a posterior uveitis. We report three cases ofatypical TINU syndrome. We reported two out of three adult patients (16, 60, and 62 years of age), two of whom were female andone male. The first patient had a panuvéitis of the left eye and a posterior uveitis of the right eye. The second patient presentedbilateral panuveitis with retinal vasculitis. The third patient had a bilateral anterior uveitis recurrent. The three patients hadproteinuria, glucosuria, aseptic leukocyturia without renal insufficiency. Renal biopsy showed tubulointerstitial nephritis withno sign of vasculitis or glomerular involvement. The etiological investigation did not find any cause (infection, medication, andsystemic illness). The patients received a local and general corticosteroid therapy associated in one case with methotrexate, whichhas resulted in rapid improvement for all three patients. This clinical case report highlights some important features of TINUsyndrome, including the increasing incidence of disease in male and adult patients, the possibility of a posterior involvement ofuveitis, and clinical presentation without kidney failure. Extensive studies are needed to elucidate the cause and pathogenesis ofthis syndrome for better management. &nbsp