Acute renal failure and uveitis: Which diagnosis is most likely in internal medicine? TINU syndrome, through two observations

5^th Global Nephrologists Annual Meeting

March 31-April 02, 2016 Valencia, Spain

Laidoudi Aicha, A Ghout, S M�©daoud, D Hakem, A Boudjelida, F Haddoum, K Kallem and A Berrah

Mohammad-Lamine-Debaghine Hospital, Algeria
Neffissa-Hamoudi Hospital, Algeria

Scientific Tracks Abstracts: J Nephrol Ther

Abstract :

NITU syndrome is characterized by the occurrence of Tubulointerstitial Nephritis (TIN) and Uveitis (U), with unknown pathogenesis, autoimmune origin has recently been proposed. We report two cases of TINU syndrome occurring in adults in which immunological disorders created differential diagnostic difficulties. Observation1: A 25year-old woman, presented with asthenia, weight loss, severe hypertension and acute unilateral anterior uveitis. She had also proteinuria, hematuria; kidney failure, and grade I hypertensive retinopathy. Kidney biopsy showed a non caseating granuloma in the interstitial tissue, and TIN with granulomatous lesions in the medullary parenchyma. All explorations was negative but Quantiferon was 10 times normal without koch�s bacillus. No other sites of granulomas. The patient partially responded to corticoid treatment. She replased after untimely stopping corticosteroids. Glucocorticoid-sparing was provided by mycophenolate mofetil. Observation2: A 46year-old patient, with family history of mother who died of CKD, presented with recurrent anterior uveitis, kidney failure, proteinuria, and inflammatory syndrome, research of infectious agents or auto-immunity origin was negative. Renal biopsy showed tubulointerstitial nephritis lesions in subacute stage; biopsy of the salivary glands showed stage III chronic lymphocytic sialadenitis without Sjogren syndrome or sarcoidosis. The patient received corticosteroid treatment. Discussion: The presence of TIN, recurrent anterior uveitis, no notion of drug intake, response to corticosteroids and exclusion of other diagnoses leads to TINU syndrome. Positivity of Quantiferon is explained by the fact that TINU syndrome is associated with high serological markers in the absence of their corresponding diseases, and presence of chronic lymphocytic sialadenitis explained by these immunological disorders without Sjogren syndrome, Both patients remained well without recurrence of uveitis 2 and 6 years later respectivlly. Conclusion: TINU syndrome is secondary to immunological disorders as evidenced interstitial infiltrate of the renal parenchyma, the inflammatory disease of the uvea and good response to corticosteroid therapy.

Biography :

Laidoudi Aicha has completed her PhD from Ferhat Abbas University and is in the final year of Post-doctoral studies at Mohamed Maherzi University School of Medicine. She is a Doctor in the department of internal medicine, Mohamed LamineDebaghine Hospital. She has many publications to her credit.

Email: aic.laid@gmail.com