Abstract:
:We report a 17-year-old male patient with tubulointerstitial nephritis and uveitis (TINU) associated with hyperthyroidism. He presented with a 2-month history of fatigue, loss of appetite, low-grade fever, and a 12-kg weight loss when he was admitted to our hospital. He had iritis, which was complicated by fibrin in the anterior chamber, diagnosed by slit-lamp examination. On laboratory examinations, deteriorated renal function (blood urea nitrogen level was 25.9 mg/dl and creatinine level was 2.82 mg/dl) and elevated urinary levels of N-acetyl-beta-D-glucosaminidase (33.1 U/l) and beta2-microglobulin (78,600 microg/l) were observed. Serum thyroid-stimulating hormone (TSH) was undetectable, at less than 0.01 microIU/ml, and free triiodothyronine and free thyroxine were elevated, up to 5.23 pg/ml and 2.85 ng/dl, respectively. The titers of antithyroglobulin and antithyroid microsomal and TSH-receptor antibodies were not elevated. Abdominal and thyroidal ultrasonography showed evident bilateral enlargement of the kidneys and diffuse enlargement of the thyroid gland. Iodine-123 scintigraphy showed low uptake in the thyroid gland. The biopsied renal specimen showed mild edema and severe diffuse infiltration of mononuclear cells and few eosinophils in the interstitium, without any glomerular or vascular abnormalities. Based on the clinical features and pathological findings, a diagnosis of TINU syndrome with associated hyperthyroidism was made. Treatment was started with 30 mg/day of prednisolone. The iritis disappeared, and the patient's clinical status improved remarkably. This case suggests the possibility of thyroid dysfunction in some patients with TINU syndrome, and we believe thyroid function should be measured in all TINU patients. Moreover, histopathological diagnosis of the thyroid glands before treatment is necessary for TINU patients with thyroid dysfunction.
journal_name
Clin Exp Nephroljournal_title
Clinical and experimental nephrologyauthors
Ebihara I,Hirayama K,Usui J,Seki M,Higuchi F,Oteki T,Kobayashi M,Yamagata Kdoi
10.1007/s10157-006-0423-xsubject
Has Abstractpub_date
2006-09-01 00:00:00pages
216-21issue
3eissn
1342-1751issn
1437-7799journal_volume
10pub_type
杂志文章abstract:BACKGROUND:Analyses of selected cases suggest that immunosuppressive treatment could reduce proteinuria and delay the progression of immunoglobulin A nephropathy (IgAN). The aim of this study was to examine the long-term effectiveness of this therapy on the clinical course of IgAN. We also examined the relationship bet...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0045-6
更新日期:2008-08-01 00:00:00
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doi:10.1007/s10157-014-0998-6
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-011-0519-9
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pub_type: 杂志文章
doi:10.1007/s10157-014-0982-1
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pub_type: 杂志文章,评审
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journal_title:Clinical and experimental nephrology
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1007/s10157-003-0267-6
更新日期:2004-03-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-014-1064-0
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doi:10.1007/s10157-013-0799-3
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doi:10.1007/s10157-012-0665-8
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pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s10157-020-01989-3
更新日期:2020-11-11 00:00:00
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pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00