A report of an adult case of tubulointerstitial nephritis and uveitis (TINU) syndrome, with a review of 102 Japanese cases

Am J Case Rep. 2015 Feb 28:16:119-23. doi: 10.12659/AJCR.892788.

Abstract

Background: Although TINU syndrome is characterized by idiopathic TIN with bilateral anterior uveitis, few reports have provided a comprehensive summary of the features of this disorder. Previous reports have suggested that many Japanese patients had HLA-A2 and -A24 (7), but there is no evidence.

Case report: A 44-year-old female was referred to our hospital due to renal dysfunction in March 2012. After admission, her symptoms improved spontaneously without medication within 2 weeks. In the outpatient clinic, she was diagnosed with idiopathic bilateral anterior uveitis in May, and her renal dysfunction relapsed in November. A renal biopsy showed diffuse TIN. We made a diagnosis of TINU syndrome because we could not explain the origin, and treated her with a systemic corticosteroid. Her renal function and ocular symptoms have been improving. The patient had HLA-A24, -B7, -DR1, -C*07: 02 and -DQB1*05: 01: 01. We collected 102 Japanese cases in PubMed, Ovid MEDLINE, and the Japanese Medical Abstracts Society and compared our case with the previous cases.

Conclusions: This disorder affects primarily young females (median age, 14 years), and the most common symptom is fever (44/102 cases). We conducted a statistical analysis using contingency table and Pearson's chi-square test, for HLA-A2 and A24, and calculated the odds ratio (OR). There are no significant differences (A2 was present in 7/22 cases and in 19/50 controls, p value (P) 0.61, OR 0.76 (95% confidence interval (CI)) 0.27-2.2; A24 was present in 10/22 cases and in 33/50 controls, P 0.10, OR 0.43, CI 0.16-1.2).

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Asian People*
  • Female
  • HLA-A Antigens
  • Humans
  • Japan / ethnology
  • Nephritis, Interstitial / diagnosis*
  • Nephritis, Interstitial / ethnology*
  • Nephritis, Interstitial / therapy
  • Risk Factors
  • Syndrome
  • Uveitis / diagnosis*
  • Uveitis / ethnology*
  • Uveitis / therapy

Substances

  • HLA-A Antigens

Supplementary concepts

  • Tubulointerstitial nephritis and uveitis