The TubuloInterstitial Nephritis and Uveitis syndrome (TINU) can be diagnosed when specific criteria are present.
(1) histopathologic criteria for tubulointerstitial nephritis
(2) clinical criteria (complete or incomplete) for tubulointerstitial nephritis
(3) uveitis characteristics
(4) another systemic disease capable of causing either uveitis or interstitial nephritis
Tubulointerstitial Nephritis Criteria
Criteria for typical uveitis:
(1) bilateral anterior uveitis with or without intermediate uveitis or posterior uveitis
(2) onset of uveitis <= 2 months before OR <= 12 months after acute interstitial nephritis
Criteria for atypical uveitis:
(1) unilateral anterior uveitis OR intermediate uveitis OR posterior uveitis
(2) onset of uveitis > 2 months before OR > 12 months after acute interstitial nephritis
(1) renal biopsy histology consistent with tubulointerstitial nephritis
(1) abnormal renal function (elevated serum creatinine, decreased creatinine clearance)
(2) abnormal urinalysis with increased beta-2-microglobulin, low grade proteinuria, urinary eosinophils, pyruria or hematuria without infection, urinary white cell casts, normoglycemic glucosuria
(3) a systemic illness lasting >= 2 weeks, with a combination of fever, weight loss, malaise, fatigue, rash, abdominal pain, flank pain, arthralgias, myalgias, anemia, abnormal liver function tests, eosinophilia, elevated ESR (> 40 mm in first hour)
Low grade proteinuria is indicated by one of the following:
(1) 1+ or 2+ urinary protein on semi-quantitative test
(2) spot urinary protein to urinary creatinine ratio < 3
(3) 24 hour urine protein with < 3.0 grams in an adult or < 3.5 grams per 1.73 meter square BSA in child
If all 3 criteria are present, then the clinical criteria are complete.
If 1 or 2 of the criteria are present, then the clinical criteria are incomplete.
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Specialty: Nephrology, Clinical Laboratory, Ophthalmology