Tubulointerstitial nephritis and uveitis (
TINU) syndrome is a
rare disease of unknown etiology defined by the combination of
tubulointerstitial nephritis,
uveitis, and biochemical abnormalities. It has been reported that TINU mainly affects adolescents and young women. Here we reported a special case regarding a 60-year-old man with
acute renal failure due to
TINU syndrome documented by renal biopsy.We present a rare case of an elderly patient, who had been suffering from a
fever for 2 weeks, characterized by sudden onset and resolving spontaneously, and accompanied by extreme
fatigue, loss of appetite, and shivering. Renal biopsy showed a
tubulointerstitial nephritis, with polymorphonuclear infiltration and acute tubulitis. In the outpatient clinic, he was diagnosed with idiopathic bilateral
anterior uveitis 1 month ago. Ophthalmological examination revealed anterior asymptomatic bilateral
uveitis.
Human leukocyte antigen (HLA) typing (
HLA-DQA1*0101/0201 and
HLA-DQB1*0303/0503) was found which supported the suspect of
TINU syndrome. The patient was treated with oral
prednisone (1 mg/kg) and continued for 8 weeks on tapering doses. Serum
creatinine normalized within 3 and 6 months later renal function also recovered completely.This case highlights that
TINU syndrome is probably an underdiagnosed disease responsible for some cases of idiopathic
anterior uveitis in elderly male patients. It is of critical importance to be aware of this syndrome by nephrologist and ophthalmologists in this special population. Further studies are needed to elucidate clinical characteristic and pathogenesis of
TINU syndrome in elderly population.