tubulointerstitial nephritis with uveitis (TINU)

Etiology

• previous infection &/or use of specific drugs (NSAIDS, antibiotics)

Epidemiology

• usually affects adolescents & young women

Pathology

• systemic inflammatory disease

Clinical manifestations

• uveitis
  • bilateral conjunctival erythema, eye pain, decreased visual acuity, photophobia consistent with anterior uveitis
• systemic manifestations
  • fever, weight loss, arthralgias, myalgias, headache are common
• tubulointerstitial nephritis has variable course
  • can present before, concurrent with, or even 1 year after uveitis

Laboratory

• elevated serum creatinine levels
• anemia, eosinophilia
• abnormal serum transaminases
• elevated serum C-reactive protein
• positive cANCA in serum or pANCA in serum
• positive antinuclear antibody
• positive rheumatoid factor
• urinalysis
  • may be normal
  • may dshow pyuria, microscopic hematuria, &/or mild proteinuria (< 1500 mg/24 hr)

Management

• progressive kidney disease is treated with prednisone

More general terms

• interstitial nephritis
• uveitis