Eye catching.

Area of Science:

• Nephrology
• Ophthalmology
• Rheumatology

Background:

• Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare idiopathic multisystem inflammatory disease.
• It primarily affects young women but can occur in any age group, presenting with acute kidney injury and bilateral anterior uveitis.
• Diagnosis can be challenging due to non-specific symptoms and the need to exclude other causes of nephritis and uveitis.

Purpose of the Study:

• To present a case of Tubulointerstitial nephritis and uveitis (TINU) syndrome in a middle-aged male with type 2 diabetes mellitus.
• To discuss the diagnostic work-up and management of this rare condition.
• To highlight the importance of considering TINU syndrome in patients with unexplained acute kidney injury and uveitis.

Main Methods:

• Case report of a 55-year-old male with type 2 diabetes mellitus presenting with nausea, vomiting, abdominal pain, epididymitis, hyperglycemia, acute kidney injury, and uveitis.
• Diagnostic work-up included infectious, autoimmune, and malignancy screening, which were negative.
• Renal biopsy was performed, revealing findings consistent with tubulointerstitial nephritis.

Main Results:

• The patient presented with symptoms suggestive of infection and hyperglycemia, which improved with treatment.
• Despite initial treatment, persistent acute kidney injury and uveitis were noted.
• Extensive work-up ruled out infectious, autoimmune, and malignant etiologies, leading to a diagnosis of TINU syndrome based on renal biopsy findings.

Conclusions:

• Tubulointerstitial nephritis and uveitis (TINU) syndrome should be considered in the differential diagnosis of acute kidney injury and uveitis, even in atypical patient populations.
• Renal biopsy is crucial for confirming the diagnosis when other causes are excluded.
• Early recognition and management may improve patient outcomes.