caa a22 4500 44588276X CHVBK 20180317145549.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10157-011-0505-2 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0505-2 Tubulointerstitial nephritis and uveitis syndrome with transient hyperthyroidism in an elderly patient [Elektronische Daten] [Keiko Yasuda, Koichi Sasaki, Masaya Yamato, Hiromi Rakugi, Yoshitaka Isaka, Terumasa Hayashi] A 69-year-old Japanese woman without any specific medical or family history was admitted to our hospital for renal insufficiency with proteinuria. On laboratory examinations, deteriorated renal function (blood urea nitrogen level was 34.9mg/dL and creatinine level was 1.78mg/dL) and elevated urinary levels of N-acetyl-β-d-glucosaminidase (23.4U/L) and β2-microgloblin (20200μg/L) were observed. We performed a renal biopsy. The biopsied specimen showed severe diffuse infiltration of mononuclear cells into the interstitium, with normal glomeruli, and these findings were compatible with acute tubulointerstitial nephritis (ATIN). At that time, ATIN seemed to be idiopathic. We performed gallium scintigraphy, and the results revealed uptake by the bilateral kidneys, thyroid gland, and right parotid gland. Serum thyroid stimulating hormone (TSH) was undetectable, free triiodothyronine was normal (3.11pg/mL), and free thyroxine was elevated to 2.4ng/dL. The titers of antithyroglobulin and antithyroid microsomal and TSH-receptor antibodies were not elevated. Two months later, burning pain and conjunctival congestion developed in both eyes. She had uveitis, as diagnosed by slit-lamp examination. Topical corticosteroid was used for the uveitis with success. We could not detect any cause of the uveitis, so a diagnosis of tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) with associated hyperthyroidism was made. Treatment was started with 15mg/day of prednisolone. Now her renal function is slowly recovering. There are few reports of TINU syndrome with transient hyperthyroidism. This case suggests the possibility of thyroid dysfunction in patients with TINU syndrome. A laboratory evaluation of thyroid function should be considered in the diagnostic evaluation of TINU syndrome. Japanese Society of Nephrology, 2011 Tubulointerstitial nephritis and uveitis syndrome nationallicence Hyperthyroidism nationallicence Elderly nationallicence Yasuda Keiko Department of Nephrology, Rinku General Medical Center, 2-23 Rinku Orai-kita, 598-8577, Izumisano, Osaka, Japan aut Sasaki Koichi Department of Nephrology, Rinku General Medical Center, 2-23 Rinku Orai-kita, 598-8577, Izumisano, Osaka, Japan aut Yamato Masaya Department of Nephrology, Rinku General Medical Center, 2-23 Rinku Orai-kita, 598-8577, Izumisano, Osaka, Japan aut Rakugi Hiromi Department of Geriatric and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan aut Isaka Yoshitaka Department of Geriatric and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan aut Hayashi Terumasa Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan aut Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 927-932 1342-1751 15:6<927 2011 15 10157 https://doi.org/10.1007/s10157-011-0505-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0505-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yasuda Keiko Department of Nephrology, Rinku General Medical Center, 2-23 Rinku Orai-kita, 598-8577, Izumisano, Osaka, Japan aut NATIONALLICENCE 700 1- Sasaki Koichi Department of Nephrology, Rinku General Medical Center, 2-23 Rinku Orai-kita, 598-8577, Izumisano, Osaka, Japan aut NATIONALLICENCE 700 1- Yamato Masaya Department of Nephrology, Rinku General Medical Center, 2-23 Rinku Orai-kita, 598-8577, Izumisano, Osaka, Japan aut NATIONALLICENCE 700 1- Rakugi Hiromi Department of Geriatric and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Isaka Yoshitaka Department of Geriatric and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Hayashi Terumasa Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 927-932 1342-1751 15:6<927 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer