PDF(Pubmed)
Abstract：
OBJECTIVE: Tubulointerstitial nephritis and uveitis (TINU) syndrome is an uncommon disease. We present a confirmed case of TINU syndrome, and a systematic review of epidemiological characteristics, clinical manifestations, management, and outcomes in Chinese patients.
METHODS: A systematic search was carried out using defined terms and updated up to September 2022, in PubMed, Web of Science, Wanfang, CNKI, and VIP, to identify reported cases of TINU in China, according to PRISMA guidelines.
RESULTS: An 18-year-old boy presented with elevated serum creatinine and 24-h urine protein level of > 2 g. Inspection result revealed acute tubulointerstitial nephritis, and bilateral uveitis. The patient was diagnosed with TINU syndrome and received treatment with methylprednisolone sodium succinate, which resulted in a significant decrease in creatinine and urinary protein levels. Systematic review identified 35 publications that met the inclusion criteria. A total of 71 cases were included in this article, of which 70 were from publications and 1 was from our hospital. The median age at onset was 42 years and was significantly lower in males than females (P < 0.05). The symptoms of uveitis often occurred after kidney injury (54%) and most uveitis was anterior (55%) and bilateral (75%). Among the 51 patients who were followed up for more than 6 months, 24 had recurrent ocular symptoms or progression to chronic uveitis. Twenty patients experienced chronic or progressive kidney disease.
CONCLUSIONS: TINU syndrome is prone to misdiagnosis because kidney damage may not occur simultaneously with uveitis. The incidence of kidney sequelae in children is lower than that in adults, and glucocorticoids are the preferred treatment.
UNASSIGNED: INPLASY202350050.
METHODS: A systematic search was carried out using defined terms and updated up to September 2022, in PubMed, Web of Science, Wanfang, CNKI, and VIP, to identify reported cases of TINU in China, according to PRISMA guidelines.
RESULTS: An 18-year-old boy presented with elevated serum creatinine and 24-h urine protein level of > 2 g. Inspection result revealed acute tubulointerstitial nephritis, and bilateral uveitis. The patient was diagnosed with TINU syndrome and received treatment with methylprednisolone sodium succinate, which resulted in a significant decrease in creatinine and urinary protein levels. Systematic review identified 35 publications that met the inclusion criteria. A total of 71 cases were included in this article, of which 70 were from publications and 1 was from our hospital. The median age at onset was 42 years and was significantly lower in males than females (P < 0.05). The symptoms of uveitis often occurred after kidney injury (54%) and most uveitis was anterior (55%) and bilateral (75%). Among the 51 patients who were followed up for more than 6 months, 24 had recurrent ocular symptoms or progression to chronic uveitis. Twenty patients experienced chronic or progressive kidney disease.
CONCLUSIONS: TINU syndrome is prone to misdiagnosis because kidney damage may not occur simultaneously with uveitis. The incidence of kidney sequelae in children is lower than that in adults, and glucocorticoids are the preferred treatment.
UNASSIGNED: INPLASY202350050.
摘要：
目的：肾小管间质性肾炎和葡萄膜炎（TINU）综合征是一种罕见的疾病。我们提出了一个确诊的TINU综合征，以及对流行病学特征的系统评价，临床表现，管理,以及中国患者的预后。
方法：使用定义的术语进行了系统搜索，并在PubMed上更新至2022年9月，WebofScience,万方,CNKI,VIP,为了确定中国报告的TINU病例，根据PRISMA指南。
结果：一名18岁男孩，血清肌酐升高，24小时尿蛋白水平>2g。检查结果显示为急性肾小管间质性肾炎，和双侧葡萄膜炎。患者被诊断为TINU综合征，并接受甲基强的松龙琥珀酸钠治疗，导致肌酐和尿蛋白水平显着下降。系统审查确定了35种符合纳入标准的出版物。本文共纳入71例，其中70来自出版物，1来自我们医院。发病年龄中位数为42岁,男性显著低于女性(P<0.05)。葡萄膜炎的症状通常发生在肾损伤后（54％），大多数葡萄膜炎发生在前部（55％）和双侧（75％）。在随访6个月以上的51例患者中，24例反复出现眼部症状或进展为慢性葡萄膜炎。20名患者经历了慢性或进行性肾脏疾病。
结论：TINU综合征容易误诊，因为肾脏损害可能不会与葡萄膜炎同时发生。儿童肾脏后遗症的发生率低于成人,糖皮质激素是首选治疗方法。
■INPLASY202350050。
方法：使用定义的术语进行了系统搜索，并在PubMed上更新至2022年9月，WebofScience,万方,CNKI,VIP,为了确定中国报告的TINU病例，根据PRISMA指南。
结果：一名18岁男孩，血清肌酐升高，24小时尿蛋白水平>2g。检查结果显示为急性肾小管间质性肾炎，和双侧葡萄膜炎。患者被诊断为TINU综合征，并接受甲基强的松龙琥珀酸钠治疗，导致肌酐和尿蛋白水平显着下降。系统审查确定了35种符合纳入标准的出版物。本文共纳入71例，其中70来自出版物，1来自我们医院。发病年龄中位数为42岁,男性显著低于女性(P<0.05)。葡萄膜炎的症状通常发生在肾损伤后（54％），大多数葡萄膜炎发生在前部（55％）和双侧（75％）。在随访6个月以上的51例患者中，24例反复出现眼部症状或进展为慢性葡萄膜炎。20名患者经历了慢性或进行性肾脏疾病。
结论：TINU综合征容易误诊，因为肾脏损害可能不会与葡萄膜炎同时发生。儿童肾脏后遗症的发生率低于成人,糖皮质激素是首选治疗方法。
■INPLASY202350050。
