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TINU syndrome : two case reports and review of literature
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A inflamação do interstício renal, juntamente com o atingimento da úvea, estabelece os dois componentes da síndrome de nefrite tubulointersticial e uveíte (TINU). Embora classicamente descrita como ocorrendo em mulheres jovens, a síndrome pode afetar um amplo espectro de doentes. Tanto a doença renal como a ocular podem ser assintomáticas e/ou aparecer com um atraso importante. A doença renal dá origem a sintomas constitucionais inespecíficos semelhantes a uma síndrome gripal, muitas vezes autolimitados e com bom prognóstico. A doença ocular surge principalmente como uma uveíte anterior bilateral de início súbito e tem uma tendência para um curso crónico, mesmo sob tratamento. Os dados clássicos indicam que a síndrome afeta 2% dos doentes com uveíte. Atualmente, reconhecem-se as características clínicas complexas da doença, acreditando-se que seja subdiagnosticada. É, portanto, imperativo ter uma alta suspeita clínica para TINU. Neste trabalho são descritos e analisados dois casos clínicos da síndrome TINU com diferentes manifestações clínicas iniciais e com mais de um ano de acompanhamento.
Inflammation of renal interstitium along with uvea involvement sets out the two components of tubulointerstitial nephritis and uveitis (TINU) syndrome. Though classically described as occurring in young females, it can affect a broad spectrum of patients. Both renal and eye disease could be asymptomatic and/or appear with an important delay. Renal disease gives rise to non-specific flu-like symptoms, often self-limited with therapeutic and with good prognosis. Eye-disease emerge mainly as a sudden-onset bilateral anterior uveitis and has a tendency for a chronic course, even under treatment. The syndrome was firstly thought to affect 2% of uveitis patients. Today, the challenging clinical features and the limited recognition are enlightened, and it is believed to be an underdiagnosed illness. It is thus imperative to have a high clinical suspicion for TINU. We describe and analyze two clinical cases of TINU syndrome with different initial clinical manifestations and over one-year of follow-up.
Inflammation of renal interstitium along with uvea involvement sets out the two components of tubulointerstitial nephritis and uveitis (TINU) syndrome. Though classically described as occurring in young females, it can affect a broad spectrum of patients. Both renal and eye disease could be asymptomatic and/or appear with an important delay. Renal disease gives rise to non-specific flu-like symptoms, often self-limited with therapeutic and with good prognosis. Eye-disease emerge mainly as a sudden-onset bilateral anterior uveitis and has a tendency for a chronic course, even under treatment. The syndrome was firstly thought to affect 2% of uveitis patients. Today, the challenging clinical features and the limited recognition are enlightened, and it is believed to be an underdiagnosed illness. It is thus imperative to have a high clinical suspicion for TINU. We describe and analyze two clinical cases of TINU syndrome with different initial clinical manifestations and over one-year of follow-up.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Síndrome de nefrite tubulointersticial e uveíte Uveíte Nefrite Auto-imunidade Oftalmologia