Neuroretinitis: a rare feature of tubulointerstitial nephritis and uveitis syndrome

Khochtali, Sana; Harzallah, O.; Hadhri, Rym; Hamdi, C.; Zaouali, Sonia; Khairallah, Moncef

doi:10.1007/s10792-013-9820-9

Cited by 17 publications

(9 citation statements)

References 10 publications

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“…However, more recent reports using SUN criteria have identified TINU patients with intermediate and panuveitis [3*,6**,14**] suggesting that these presentations could have been previously underappreciated. Other rare descriptions of posterior findings in the most recent literature include small hypopigmented chorioretinal scars [14**,16], delayed multifocal choroiditis [17], acute posterior multifocal placoid pigment epitheliopathy [18], choroidal neovascular membranes [19], and neuroretinitis [14,20]. Atypical anterior findings such as granulomatous keratic precipitates and iris nodules have also been described in cases of TINU [5].…”

Section: Presentationmentioning

confidence: 99%

Tubulointerstitial nephritis and uveitis

Pakzad-Vaezi

Pepple

2017

Current Opinion in Ophthalmology

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Purpose of review Tubulointerstitial nephritis and uveitis (TINU) is an important yet under-recognized ocular inflammatory syndrome. This review summarizes key historical publications that identified and defined the syndrome, and more recent literature that reveal the importance of urinary beta-2 microglobulin testing and kidney biopsy in the diagnostic evaluation of patients with TINU. Additionally, research studies providing new insights into disease pathogenesis are highlighted. Recent findings In contrast with initial reports of TINU manifesting exclusively as an anterior uveitis in pediatric patients, more recent reports have identified TINU in patients of all ages with a wide range of ocular manifestations. Urinary beta-2 microglobulin has emerged as a sensitive and specific laboratory screening test, and the role of kidney biopsy in differentiating TINU from sarcoidosis continues to evolve. Genetic studies have identified HLA-DQA1*01, HLA-DQB1*05, and HLA-DRB1*01 as high risk alleles and the identification of anti-mCRP antibodies suggests a role for humoral immunity in disease pathogenesis. Management strategies have evolved to include systemic anti-inflammatory treatment as a result of important outcome studies in patients with significant renal and ocular disease. Summary With greater recognition, understanding, and treatment of this syndrome, both ocular inflammation and renal disease can be better addressed.

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Section: Presentationmentioning

confidence: 99%

Tubulointerstitial nephritis and uveitis

Pakzad-Vaezi

Pepple

2017

Current Opinion in Ophthalmology

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“…Visual complication was in one of our patients who had complicated cataract. Mostly, uveitis is nongranulomatous, rarely it can be granulomatous,[ 6 ] as seen in our second case.…”

Section: Discussionmentioning

confidence: 69%

Tubulointerstitial nephritis and uveitis syndrome: Our experience

et al. 2020

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Tubulointerstitial nephritis and uveitis (TINU) syndrome is a distinct oculorenal disorder of immune origin and accounts for some cases of unexplained recurrent uveitis. We report three cases of TINU syndrome, one of which had primarily come to us with uveitis. It is the occurrence of tubulointerstitial nephritis and uveitis in a patient in the absence of other systemic diseases that can cause either interstitial nephritis or uveitis. TINU syndrome is a diagnosis of exclusion. Our aim in reporting these cases is to highlight the association of nephritis and uveitis, which together form a distinct clinical disorder called the TINU syndrome.

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“…These included CME, papilledema, peripheral vasculitis, multifocal choroiditis, and peripapillary CNV. In this regard, posterior atypical findings are being described in an increasing number of TINU cases [ 21 , 22 , 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Tubulointerstitial Nephritis and Uveitis Syndrome (TINU): A Case Series in a Tertiary Care Uveitis Setting

Paroli

Cappiello

Staccini

et al. 2022

JCM

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Background: Tubulointerstitial nephritis and uveitis syndrome (TINU) is a rare disorder typically characterized by sudden-onset non-granulomatous anterior uveitis associated with tubulointerstitial nephritis (TIN). However, the prevalence and clinical features of TINU are still a matter of debate. To add information about TINU, we describe here the clinical features of a series of patients affected by TINU in a retrospective study. Methods: A total of 9358 clinical records of both adult and pediatric patients up to 21 years of age, referred to the Uveitis Center of the Sapienza University of Rome, were examined. The medical records covered a period from 1990 to 2020. Various demographic and clinical features were analyzed in patients who met the criteria for TINU. Results: Twenty-one patients with TINU were identified. TINU was classified as definite, possible, or probable by the currently recognized international criteria. The median age at diagnosis was 14 years (interquartile range 12–35). Females were predominant (15/21, 71.4%). In most cases (14/21, 66.6%), patients developed ocular disease concurrently with renal disease. The most frequent type of ocular involvement was bilateral anterior uveitis (9/21, 42.8%). In two cases, patients presented with bilateral intermediate uveitis; in three cases, they presented with bilateral or unilateral alternating posterior uveitis; and in four cases, they presented with bilateral panuveitis. In one case, the uveitis was anterior in the right eye (OD) and posterior in the left eye (OS), and two cases presented with bilateral asynchronous or unilateral alternating anterior uveitis. All patients received treatment with systemic corticosteroids and topical ocular therapy. At the end of the follow-up, a significant improvement in ocular signs and symptoms with a return to normal visual acuity was generally observed. In all patients, acute kidney injury (AKI) reverted completely and none progressed to chronic kidney disease (CKD). Conclusions: Patients with TINU may often present with atypical uveitis. We suggest that patients with sudden-onset uveitis, even if not bilateral anterior, should be referred to a nephologist for an assessment of the possible presence of renal disease.

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Neuroretinitis: a rare feature of tubulointerstitial nephritis and uveitis syndrome

Cited by 17 publications

References 10 publications

Tubulointerstitial nephritis and uveitis

Tubulointerstitial nephritis and uveitis

Tubulointerstitial nephritis and uveitis syndrome: Our experience

Tubulointerstitial Nephritis and Uveitis Syndrome (TINU): A Case Series in a Tertiary Care Uveitis Setting

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