Tubulointerstitial nephritis and uveitis (TINU) is a rare syndrome in which idiopathic interstitial nephritis coexists with chronic recurrent uveitis. This syndrome often represents systemic disorders such as arthralgia, rash, prolonged fever, anaemia and ocular symptoms that require medication including glucocorticoid administration. Recently, novel urinary biomarkers, such as kidney injury molecule-1, neutrophil gelatinase-associated lipocalin and liver-type fatty acid-binding protein, were shown to be associated with tubulointerstitial damage and were elevated in interstitial nephritis. We evaluated these urinary biomarkers in a case of TINU syndrome before and during treatment and found that their levels were elevated at onset and decreased during treatment, especially NGAL. We conclude that these urinary biomarkers are useful to evaluate and predict prognosis in interstitial nephritis.
Kidney injury molecule-1 Liver-type fatty acid-binding protein Neutrophil gelatinase-associated lipocalin Urinary biomarkers Tubulointerstitial nephritis and uveitis syndrome
This is a preview of subscription content, log in to check access.
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest.
Research involving human participants and informed consent
Informed consent was obtained from all individual participants including in this case report.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Dobrin RS, Vernier RL, Fish AL. Acute eosinophilic interstitial nephritis and renal failure with bone marrow-lymph node granulomas and anterior uveitits. A new syndrome. AmJ Med. 1975;59:325–33.CrossRefGoogle Scholar
Vohra S, Eddy A, Levin AV, Taylor G, Laxer RM. Tubulointerstitial nephritis and uveitis in children and adolescents. Pediatr Nephrol. 1999;13:426–32.CrossRefPubMedGoogle Scholar
Takemura T, Okada M, Hino S, et al. Course and outcome of Tubulointerstitial nephritis and uveitis syndrome. Am J Kid Dis. 1999;34:1016–21.CrossRefPubMedGoogle Scholar
Li C, Su T, Chu R, Li X. Yang L. Tubulointerstitial nephritis with uveitis in Chinese adults. Clin J Am Nephrol. 2014;9:21–8.CrossRefGoogle Scholar
Nozaki Y, Kinoshita K, Yano T, et al. Estimation of kindey injury molecule-1(Kim-1) in patients with lupus nephritis. Lupus. 2014;23:769–77.CrossRefPubMedGoogle Scholar
Sinnamon KT, Courtney AE, Harron C, O’Rourke DM, Mullan RN. Tubulointerstitial nephritis and uveitis (TINU) syndrome: epidemiology, diagnosis and management. NDT Plus. 2008;1:112–6.PubMedPubMedCentralGoogle Scholar
Legendre M, Devilliers H, Perad L, et al. Clinicopathologic characteristics, treatment, and outcomes of tubulointerstitial nephritis and uveitis syndrome in adults: a national retrospective strobe-compliant study. Medicine (Baltimore). 2016;95:e3964.CrossRefGoogle Scholar
Mandeville JT, Levinson RD, Holland GN. The tubulointerstitial nephritis and uveitis syndrome. Surv Ophthalmol. 2001;46:195–208.CrossRefPubMedGoogle Scholar
Yu Wu L, Yang T, Su C, Wang G, Liu Xiao-mei, Li. Pathological significance of panel of urinary biomarkers in patients with drug-induced tubulointerstitial nephritis. Clin J AmSoc Nephrol. 2010;5:1954–59.CrossRefGoogle Scholar
Mori K, Nakao K. Neutrophil gelatinase-associated lipocalin as the real-time indicator of active kidney damage. Kidney Int. 2007;71:967–70.CrossRefPubMedGoogle Scholar
Cowland JB, Sorensen OE, Sehested M, Borregaard N. Neutrophil gelatinase- associated lipocalin is up-regulated in human epithelial cells by IL-1 beta, but not by TNF-alpha. J Immunol. 2003;171:6630–39.CrossRefPubMedGoogle Scholar
Kuwabara T, Mori K, Mukoyama M, et al. Urinary neutrophil gelatinase-associated lipocalin levels reflect damage to glomeruli, proximal tubules, and distal nephrons. Kidney Int. 2009;75:285–94.CrossRefPubMedGoogle Scholar
Ichimura T, Joseph V, Boncentre, Veronique, Bailly, et al. Kidney injury molecule-1, a putative epithelial cell adhesion molecule containing a novel immunoglobulin domain, is up-regulated in renal cells after injury. J Biol Chem. 1998;273:4135–42.CrossRefPubMedGoogle Scholar
van Timmeren MM, van den Heuvel MC, Bailly V, Bakker SJL, van Goor H, Stegeman CA. Tubular kidney injury molecule-1 (KIM-1) in human renal disease. J Pathol. 2007;212:209–17.CrossRefPubMedGoogle Scholar
Ichimura T, Asseldonk EJ, Humphreys BD, Gunaratnam L, Duffield JS, Bonventre JV. Kidney injury molecule-1 is a phosphatidylserine receptor that confers a phagocytic phenotype on epithelial cells. J Clin Invest. 2008;118:1657–68.CrossRefPubMedPubMedCentralGoogle Scholar
Kamijo-Ikemori A, Sugaya T, Obama A, et al. Liver-type fatty acid-binding protein attenuates renal injury induced by unilateral ureteral obstruction. Am J Pathol. 2006;169:1107–17.CrossRefPubMedPubMedCentralGoogle Scholar
Ferguson MA, Vaidya VS, Waikar SS, et al. Urinary liver-type fatty acid protein predicts adverse outcomes in acute kidney injury. Kidney Int. 2010;77:708–14.CrossRefPubMedGoogle Scholar