[Tubulo-interstitial nephritis and uveitis syndrome--TINU syndrome].
[Tubulo-interstitial nephritis and uveitis syndrome--TINU syndrome].
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肾小管间质性肾炎葡萄膜炎综合征——TINU综合征[J].
DOI：
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发表时间：
2000
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影响因子：
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通讯作者：
P. Yitzhaki
中科院分区：
文献类型：
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作者：
P. Yitzhaki
急性肾小管间质性肾炎和葡萄膜炎（TINU综合征）在一个53岁的妇女报告。这种罕见的综合征是27年前由Dobrin等人描述的。从那时起，大约有50个病例被描述。这种综合征可以出现在任何年龄，但大多数患者都在20岁以下；大约75%是雌性。临床特征包括疲劳、全身不适、体重减轻、发烧、盗汗、厌食、恶心呕吐、脸色苍白、夜尿症、多尿症、关节痛和皮疹。眼部受累通常包括前葡萄膜炎，但有时是后侧；大多数情况下，葡萄膜炎是双侧的。特征性实验室表现为贫血，沉降速度快，肾小球滤过率降低，血清肌酐和尿素升高。由于多克隆伽玛病和β 2微球蛋白升高，总蛋白增加。尿分析特征性地显示蛋白尿和β 2微球蛋白尿。肾活检的组织病理学特征是肾小管间质性肾炎的特征。葡萄膜炎可在肾病发病前、伴发或随发。该综合征的发病机制和病因尚不清楚。治疗包括大剂量的皮质类固醇，但治疗的必要性尚不清楚，因为有证据表明会自发改善。虽然肾病的预后良好，大多数病例是可逆的，但葡萄膜炎容易复发。
Acute tubulo-interstitial nephritis and uveitis (TINU syndrome) in a 53-year-old woman is reported. This rare syndrome was described 27 years ago by Dobrin et al. Since then about 50 cases have been described. The syndrome can appear at any age but most patients are under 20 years; about 75% are females. Clinical characteristics include fatigue, general malaise, weight loss, fever, night sweats, anorexia, nausea and vomiting, pallor, nocturia, polyuria, arthralgia and skin rash. Ocular involvement usually includes anterior uveitis but is sometimes posterior; in most cases the uveitis is bilateral. The characteristic laboratory findings are anemia, rapid sedimentation rate, decreased glomerular filtration rate with increased serum creatinine and urea. Total protein is increased because of polyclonal gammopathy and elevated beta 2-microglobulin. Urinalysis characteristically reveals proteinuria and beta 2-microglobulinuria. The histopathologic features on renal biopsy are characteristic of tubulo-interstitial nephritis. Uveitis can precede, accompany or follow onset of the nephropathy. The pathogenesis and etiology of the syndrome are as yet unknown. Treatment consists of large doses of corticosteroids, but the necessity for treatment is unclear, since there is evidence of spontaneous improvement. Although the prognosis of the nephropathy is favorable and most cases are reversible, the uveitis tends to recur.