Unusual clinical course, Challenging differential diagnosis
Mahmoud Kamel, Bijin Thajudeen, Erika Bracamonte, Amy Sussman, Yeong-Hau H. Lien
Department of Nephrology, College of Medicine, University of Arizona, Tucson, AZ, USA
Am J Case Rep 2014; 15:530-533
Tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) is a diagnosis of exclusion based on the presence of uveitis and acute tubulointerstitial nephritis in the absence of other disease entities known to cause both of these disorders. The proximal tubule is frequently affected by this syndrome, resulting in a wide range of presentations that vary from proteinuria to full picture of Fanconi syndrome. However, distal tubular involvement is not common.
Case Report: A 32-year-old female patient presented with polyuria, polydipsia and painful red eyes. Her water deprivation test and desmopressin test results were consistent with nephrogenic diabetes insipidus. Her kidney biopsy showed acute tubulointerstitial nephritis. Her eye exam was consistent with uveitis. To our knowledge, this is the first reported case of nephrogenic diabetes insipidus due to tubulointerstitial nephritis and uveitis syndrome.
Conclusions: Tubulointerstitial nephritis and uveitis syndrome (TINU) syndrome can present with multiple renal tubular defects, including nephrogenic diabetes insipidus.
Keywords: Diagnosis, Differential, Biopsy, Adult, Nephritis, Interstitial - etiology, Polycystic Kidney Diseases - diagnosis, Uveitis - etiology