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The Tubulointerstitial Nephritis and Uveitis Syndrome (TINU-Syndrom)

1Fünfstück C., 1Augsten R., 1Königsdörffer E., 1Strobel J., 2Holzhausen H.-J.,
1Friedrich-Schiller-Universität Jena, Klinik für Augenheilkunde (Jena)
2Martin-Luther-Universität, Klinik und Poliklinik für Augenheilkunde, Arbeitsbereich für experimentelle Elektroophthalmologie (Halle/Saale)

An 18 years old patient was hospitalized with decreased visual acuity, eye pain, redness and photophobia in his right eye. In his case history existed an acute renal failure caused by an tubulointerstitial nephritis two month ago. Conjunctival injection, anterior chamber cells (laser flare cell meter: 16 cells), flare and keratic precipitates probably have been the results of a strong acute iridocyclitis of the right eye. At the time of hospitalisation the analysis of kidney parameters has been normal again. There was no evidence for systemic inflammation. A medicinal therapy and systemic disease have also been excluded from the cause of intraocular infection. Because of the constellation of acute tubulointerstitial nephritis and acute iridocyclitis was diagnosed the TINU-Syndrom. Eight days after starting a local anti-inflammatory therapy (IndocolirR, Inflanefran-forteR) in combination with the use of Mydriatics all signs of iridocyclitis have been clearly reduced. The patient could be demissed with full visual acuity. TINU-Syndrom is a rare disease. The ocular inflammation must occur within 12 months of the acute interstitial nephritis. The median age of onset seems to be the first decade. There exists a female predominance (female/male = 3/1) and probably an association with HLA-Types -A2, -A24, -DR4, -B27. In view of often diagnosed idiopathic uveitis where no cause can be found could be also thought of tubulointerstitial nephritis and uveitis-syndrom.