Clinical features in tubulointerstitial nephritis and uveitis (TINU) syndrome
Clinical features in tubulointerstitial nephritis and uveitis (TINU) syndrome
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DOI：
10.1016/j.ajo.2005.04.019
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发表时间：
2005-10-01
影响因子：
4.2
通讯作者：
Ohno, S
中科院分区：
文献类型：
--
作者：
Goda, C;Kotake, S;Ohno, S
目的：分析日本肾小管间质性肾炎和葡萄膜炎 (TINU) 综合征的临床特征，特别是葡萄膜炎的恶化或复发。设计：回顾性观察研究。方法：我们回顾了 12 例经肾活检诊断为 TINU 综合征的患者的临床特征，这些患者在眼科接受评估和治疗。 北海道大学医院。视力采用十进视力测量。结果：患者年龄10～33岁，平均21岁，女性占83%。 11 名患者 (92%) 双眼均受到影响。所有12名患者最初均出现眼部症状，以充血为主诉。我们诊断患者患有葡萄膜炎，并进行了血液检查和尿液分析。尿液分析确实显示出特征性的发现，最显着的是糖尿、β2 微球蛋白增加（>= 正常水平的 10 倍）以及大部分患者中 N-乙酰氨基葡萄糖水平增加。 6 名患者 (50%) 出现葡萄膜炎复发或恶化。在恶化或复发性葡萄膜炎中，炎症更严重（>= 3 + 眼前节细胞）。眼部炎症一般对口服皮质类固醇治疗反应良好，皮质类固醇剂量为泼尼松龙 40 mg 时复发次数较低。结论：眼科医生在 TINU 综合征患者的初步发现中发挥着重要作用。由于葡萄膜炎恶化或复发时炎症更为严重，因此在局部治疗难治性葡萄膜炎的情况下，应尽早考虑口服皮质类固醇。 （美国眼科杂志 2005 年。(c) 2005 年，Elsevier Inc. 保留所有权利。）
PURPOSE: To analyze clinical features of the tubulointerstitial nephritis and uveitis (TINU) syndrome in Japan, especially exacerbations or recurrences of uveitis.DESIGN: Retrospective observational study.METHODS: We reviewed the clinical features in 12 patients with TINU syndrome diagnosed by renal biopsy, who were evaluated and treated at the Department of Ophthalmology, Hokkaido University Hospital. Visual acuity was measured using decimal visual acuity.RESULTS: Patient age ranged from 10 to 33 years (mean 21 years), and females accounted for 83% of the cases. Both eyes were affected in 11 patients (92%). All 12 patients initially experienced ocular symptoms, with hyperemia being the chief complaint. We diagnosed patients as having uveitis and conducted blood tests and urinalysis. Urinalysis did show characteristic findings, most notably glucosuria, increased beta 2 microglobulin that were >= 10 times that of normal levels, and increased N-acetylglucosaminidose levels in a high percentage of patients. Recurrent or exacerbating uveitis was seen in six patients (50%). In exacerbated or recurrent uveitis, inflammation was more severe (>= 3 + cells of the anterior eye segment). The ocular inflammation generally responded well to treatment with oral corticosteroids, and the number of recurrences was lower at corticosteroid doses of :prednisolone 40 mg.CONCLUSIONS: Ophthalmologists play an important role in the initial discovery of patients with TINU syndrome. Because inflammation was more severe in exacerbated or recurrent uveitis, in instances where uveitis is refractory to local therapy, oral corticosteroids should be considered as early as possible. (Am J Ophthalmol 2005. (c) 2005 by Elsevier Inc. All rights reserved.)