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学科主题临床医学
Tubulointerstitial Nephritis with Uveitis in Chinese Adults
Li, Cui; Su, Tao; Chu, Rong; Li, Xiaomei; Yang, Li1
刊名CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
2014-01-07
DOI10.2215/CJN.02540313
9期:1页:21-28
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Urology & Nephrology
研究领域[WOS]Urology & Nephrology
关键词[WOS]C-REACTIVE PROTEIN ; ACUTE INTERSTITIAL NEPHRITIS ; RENAL-ALLOGRAFT PATHOLOGY ; OF-THE-LITERATURE ; ANTERIOR UVEITIS ; TINU SYNDROME ; DISEASE-ACTIVITY ; SERUM ; CLASSIFICATION ; AUTOANTIBODIES
英文摘要

Background and objectivesTubulointerstitial nephritis and uveitis (TINU) syndrome is considered a rare cause of acute tubulointerstitial nephritis (ATIN) that is usually associated with renal recovery. This study sought to investigate the diagnosis, prognosis, and contributing factors of TINU syndrome using a large cohort of patients with prospective follow-up.Design, setting, participants, & measurementsThis study included patients with TINU syndrome from a prospective cohort of patients with ATIN from 2007 to 2012. Clinical-pathologic data were collected at biopsy and autoantibodies against modified C-reactive protein (mCRP-Ab) were measured. Serum levels and renal tissue expression of Kreb von den Lunge-6 were also detected. Independent risk factors for poor renal outcome at 12 months and late-onset uveitis were analyzed.ResultsThirty-one patients (28%) with biopsy-proven ATIN were classified as having TINU syndrome. Of these patients, 18 (58%) developed late-onset uveitis and were misdiagnosed as having drug-induced ATIN at the time of biopsy. An abnormal level of mCRP-Ab was an independent risk factor for late-onset uveitis (odds ratio, 14.7; 95% confidence interval, 3.4 to 64.0). Patients with TINU syndrome and drug-induced ATIN had comparable levels of Kreb von den Lunge-6 in both serum and renal tissues. Ninety-two percent of patients developed stage 3-4 CKD and/or tubular dysfunction by 12 months postbiopsy. Age, serum creatine level, erythrocyte sedimentation rate, and the presence of concomitant thyroid disease or leukocyturia were related to poor renal outcome. Relapse was seen in 36% (11 of 31) of patients and potentiated poor renal outcome.ConclusionsThe diagnosis of TINU syndrome can be missed in a large fraction of patients with ATIN because uveitis can present well after the onset of tubulointerstitial nephritis. Elevated mCRP-Ab levels may be useful in predicting late-onset uveitis TINU syndrome. Unfortunately, patients with TINU tended to have frequent relapses and most patients had incomplete renal recovery. Long-term follow-up is needed to prevent misdiagnosis and properly manage TINU syndrome.

语种英语
WOS记录号WOS:000329364700006
项目编号81070549
资助机构National Natural Science Foundation of China
引用统计
被引频次:17[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/56061
专题北京大学第一临床医学院_肾脏内科
作者单位1.Peking Univ, Inst Nephrol, Beijing 100871, Peoples R China
2.Minist Hlth China, Key Lab Renal Dis, Beijing, Peoples R China
3.Peking Univ, Dept Med, Div Renal, Hosp 1, Beijing 100034, Peoples R China
推荐引用方式
GB/T 7714
Li, Cui,Su, Tao,Chu, Rong,et al. Tubulointerstitial Nephritis with Uveitis in Chinese Adults[J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY,2014,9(1):21-28.
APA Li, Cui,Su, Tao,Chu, Rong,Li, Xiaomei,&Yang, Li.(2014).Tubulointerstitial Nephritis with Uveitis in Chinese Adults.CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY,9(1),21-28.
MLA Li, Cui,et al."Tubulointerstitial Nephritis with Uveitis in Chinese Adults".CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 9.1(2014):21-28.
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