Two Cases of Uveitis with Tubulointerstitial Nephritis in HTLV-1 Carriers

Abstract

Background: Although the tubulointerstitial nephritis and uveitis (TINU) syndrome has been reported, there are only a few reports in the ophthalmological literature. The ocular findings usually appear later than the renal findings, and a renal biopsy is required for a definitive diagnosis. Cases: Case 1 was a 15-year-old Japanese girl who was a carrier of the human T lymphotropic virus, type 1 (HTLV-1). She had tubulointerstitial nephritis, anterior uveitis, posterior retinal edema in the right eye, and peripheral vasculitis OU. Case 2 was a 56-year-old Japanese woman who was also a carrier of HTLV-1. Previously she had been diagnosed with Graves' disease, anterior uveitis, and vitreous opacity. Several years later tubulointerstitial nephritis was diagnosed. Observations: In both patients interstitial nephritis was diagnosed and systemic steroid therapy was effective. Conclusions: It is difficult for ophthalmologists to diagnose the TINU syndrome because the renal biopsy is performed by a pediatrician or an internist. This may be why ophthalmologic descriptions are rare in cases of TINU syndrome, even though the ocular findings reported in the literature are characteristic. This is the first case report of TINU syndrome in patients with HTLV-1. Ophthalmologists should pay more attention to the uveitis in the TINU syndrome.