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Tubulointerstitial nephritis and uveitis syndrome

Mackensen, Friederikea; Billing, Heikob

Current Opinion in Ophthalmology: November 2009 - Volume 20 - Issue 6 - p 525–531
doi: 10.1097/ICU.0b013e3283318f9a
Ocular manifestations of systemic disease: Edited by Russell W. Read

Purpose of review Tubulointerstitial nephritis and uveitis syndrome (TINU) is a specific form of intraocular inflammation (uveitis) combined with kidney disease that was first described in two patients by Dobrin et al. [1] in 1975. Since then, approximately 200 more cases have been published. The cause of the disease is still unknown. A hypersensitivity reaction is suspected, especially an infection or very rarely a medication reaction is thought to trigger the disease. It is considered to be a rare disease and thus unfortunately is still unfamiliar to most ophthalmologists. Therefore, it is frequently overlooked in the differential diagnosis. In this review we want to show advances in diagnostics and treatment as well as progress in deciphering the pathogenesis.

Recent findings Beta-2 microglobulin (Ub2MG) analysis in urine and human leukocyte antigen (HLA) typing is helpful to diagnose TINU cases. A high association of HLA-DRB1*01 has been shown with TINU. A first single case report suggests a common antibody production against ocular and renal proteins.

Summary TINU is a common cause of uveitis among patients who present with bilateral, anterior uveitis of sudden onset. It is more frequent in children and apparently in boys. Although the activity of the eye disease can persist for many months, it is usually controlled with little treatment and the outcome is very good.

aDepartment of Ophthalmology, Interdisciplinary Uveitis Centre, Germany

bUniversity Children's Hospital Heidelberg, University of Heidelberg, Germany

Correspondence to Friederike Mackensen, MD, FEBO, Interdisciplinary Uveitis Centre, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany Tel: +49 6221 566999; fax: +49 6221 5633549

© 2009 Lippincott Williams & Wilkins, Inc.