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| - | ====== Tubulointerstitial Nephritis and Uveitis Syndrome (TINU) ====== | ||
| - | ==== Diagnostic Criteria ==== | ||
| - | **Standardization of Uveitis Nomenclature Criteria 2021** | ||
| - | ==Clinical Criteria== | ||
| - | - Anterior uveitis with our without intermediate/ | ||
| - | - Anterior chamber cell | ||
| - | - If vitritis, choroiditis or retinal vasculitis anterior chamber inflammation is also present | ||
| - | - Tubulointerstitial nephritis | ||
| - | - Biopsy proven -OR- | ||
| - | - Elevated urine β-2 microglobulin -AND- | ||
| - | - Abnormal urinalysis or elevated creatinine | ||
| - | ==Exclusion criteria== | ||
| - | * Positive Syphilis serology | ||
| - | * Evidence of Sarcoidosis | ||
| - | * bilateral hilar adenopathy -OR- | ||
| - | * tissue biopsy with non-caseating granulomata | ||
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| - | ====Prevalence in Pediatric Populations==== | ||
| - | * Up to 32% in those with sudden onset bilateral anterior uveitis | ||
| - | * In those with biopsy proven tubulointerstitial nephritis, 46% had uveitis but 84% if they were screened at the outset, then 3 and 6 months later.(3) | ||
| - | * [[https:// | ||
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| - | ====Disease Course==== | ||
| - | |||
| - | * 88% have a chronic course with frequent relapses | ||
| - | * Active disease can last > 2 years | ||
| - | * 50% recurrence in some studies upon cessation of steroids | ||
| - | |||
| - | ====Treatment==== | ||
| - | * Topical and oral steroids is the most common treatment.(3) | ||
| - | * Prednisone 2 mg/kg/day to start given BID max dose of 60 mg | ||
| - | * Tapering dose depends on kidney function testing | ||
| - | * Given frequent long term need for steroids consider steroid sparing agents when possible | ||
| - | * The following have been used in various studies | ||
| - | * methotrexate (may accumulate in the kidneys and cause toxicity) | ||
| - | * mycofphenolate mofetil | ||
| - | * azathioprine | ||
| - | * TNFα inhibitors | ||
| - | * adalimumab | ||
| - | * infliximab | ||
| - | * golimumab | ||
| - | * tocilizumab | ||
| - | ====Resources==== | ||
| - | - {{:: | ||
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| - | {{tag>> | ||