30-j?hriger Mann mit Fieber, Gewichtsverlust und leicht erh?htem Kreatinin

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• 作者：Dr. T. Weinreich (1)
  R. Waldherr (2)
  
• 关键词：TINU ; Syndrom ; Tubulointerstitielle Nephritis ; Uveitis ; Tubul?re Proteinurie ; β2 ; Mikroglobulin ; Sarkoidose ; Lymphomonozyt?re Infiltration ; TINU syndrome ; Tubulointerstitial nephritis ; Uveitis ; Tubular proteinuria ; β2 ; microglobulin ; Sarcoidosis ; Lymphomonocytic infiltration
• 刊名：Der Nephrologe
• 出版年：2009
• 出版时间：September 2009
• 年：2009
• 卷：4
• 期：5
• 页码：441-443
• 全文大小：344KB
• 参考文献：1. Takemura T, Okada M, Hino S et al (1999) Course and outcome of tubulointerstitial nephritis and uveitis sindrome. Am J Kidney Dis 24:1016-021 CrossRef
  2. Sinnamon KT, Courtney AE, Harron C et al (2008) Tubulointerstitial nephritis and uveitis (TINU) syndrome: Epidemiology, diagnosis and management. Nephrol Dial Transplant. plus 2:112-16 CrossRef
  3. Izzedine H (2008) Tubulointerstitial nephritis and uveitis syndrome (TINU): A step forward to understanding an elusive oculorenal syndrome. Nephrol Dial Transplant 23:1095-097 CrossRef
  4. Hofmann N, Müller KM, Morath C et al (2006) Lymphoid interstitial lung disease in a patient with acute tubulointerstial nephritis and uveitis: A new facet of a rare syndrome? Am J Kidney Dis 47:E55–E59 CrossRef
  5. Abed L, Merouani A, Haddad AE et al (2008) Presence of autoantibodies against tubular and uveal cells in a patient with tubulointerstitial nephritis and uveitis (TINU) syndrome. Nephrol Dial Transplant 23:1452-455 CrossRef
  
• 作者单位：Dr. T. Weinreich (1)
  R. Waldherr (2)
  
  1. Nephrologisches Zentrum, Schramberger Str. 28, 78054, Villingen-Schwenningen, Deutschland
  2. Gemeinschaftspraxis für klinische Pathologie und Zytologie, Heidelberg, Deutschland
  

文摘

A 30-year-old man presented with recurrent febrile episodes and B symptoms. Laboratory analyses were remarkable for elevated creatinine and CRP levels, increased erythrocyte sedimentation rate, glycosuria, and proteinuria. Sonography showed an indistinct parenchyma-renal pelvis border and slightly increased echogenicity at the edge of the parenchyma. Kidney biopsy revealed tubulointerstitial nephritis. Uveitis developed later and TINU syndrome was diagnosed. In younger patients who present with a clinical picture of inflammatory systemic disease with reduced kidney function, TINU syndrome should be considered in the differential diagnosis. Determining factors for the diagnosis of TINU syndrome are slight proteinuria with tubular pattern, elevated β2-microglobulin excretion, and lack of glomerular hematuria. Ocular changes can develop with considerable delay subsequent to the appearance of general symptoms. Differential diagnoses include sarcoidosis, vasculitides, Sj?gren’s syndrome, rheumatoid arthritis, Wegener’s granulomatosis, tuberculosis, and Beh?et’s syndrome.