Suppr超能文献

肾小管间质性肾炎和葡萄膜炎综合征的病程及预后

Course and outcome of tubulointerstitial nephritis and uveitis syndrome.

作者信息

Takemura T, Okada M, Hino S, Fukushima K, Yamamoto S, Miyazato H, Maruyama K, Yoshioka K

机构信息

Department of Pediatrics, Kinki University School of Medicine, Osaka-sayama 589-8511, Japan.

出版信息

Am J Kidney Dis. 1999 Dec;34(6):1016-21. doi: 10.1016/S0272-6386(99)70006-5.

Abstract

We report here the clinical features and outcomes of 10 patients, aged 11 to 21 years (median, 13.0), with idiopathic tubulointerstitial nephritis (TIN) and uveitis syndrome (TINU syndrome). The initial symptoms were visual impairment in 7 patients and prolonged fever, anemia, or asthenia in 4 patients. An increase in urinary beta(2)-microglobulin was noticed at the initial checkup in all patients, including 2 patients who showed the normal ranges of 24-hour protein excretion. Creatinine clearance was decreased in 8 patients. TIN was found simultaneously with ocular symptoms in 7 patients and preceded these symptoms in the remaining 3 patients. Percutaneous renal biopsy indicated tubulointerstitial lesions in varying degrees. The histological grade of TIN was correlated with urinary beta(2)-microglobulin levels. Systemic steroid therapy was performed in 7 patients because of the progression of uveitis. The 10 patients were followed-up for 16 to 94 months (median, 31.0 months). In all patients, creatinine clearance recovered to the normal ranges (>/=70 mL/min/1.73 m(2)) mostly within 1 year. Urinary beta(2)-microglobulin excretion gradually declined but was slightly elevated in 4 patients at the latest checkup. Uveitis recurred in all 10 patients, which did not affect the renal status. Our findings indicate that early referral of patients from ophthalmologists and determination of beta(2)-microglobulin in the urine is helpful for the early discovery of TINU syndrome. In children and adolescents with this syndrome, TIN spontaneously resolves and its long-term prognosis is good, but uveitis often relapses. Systemic steroids may be required for uveitis, but not for TIN.

摘要

我们在此报告10例年龄在11至21岁(中位数为13.0岁)的特发性肾小管间质性肾炎(TIN)合并葡萄膜炎综合征(TINU综合征)患者的临床特征及预后情况。初始症状方面,7例患者出现视力障碍,4例患者出现持续发热、贫血或乏力。所有患者在初次检查时均发现尿β2-微球蛋白升高,其中2例患者24小时蛋白排泄量在正常范围。8例患者肌酐清除率降低。7例患者的TIN与眼部症状同时发现,其余3例患者TIN先于眼部症状出现。经皮肾活检显示不同程度的肾小管间质病变。TIN的组织学分级与尿β2-微球蛋白水平相关。7例患者因葡萄膜炎进展接受了全身类固醇治疗。10例患者随访16至94个月(中位数为31.0个月)。所有患者的肌酐清除率大多在1年内恢复至正常范围(≥70 mL/min/1.73 m²)。尿β2-微球蛋白排泄逐渐下降,但在最近一次检查时,4例患者略有升高。10例患者葡萄膜炎均复发,但未影响肾脏状况。我们的研究结果表明,眼科医生早期转诊患者并检测尿β2-微球蛋白有助于早期发现TINU综合征。在患有该综合征的儿童和青少年中,TIN可自发缓解且长期预后良好,但葡萄膜炎常复发。葡萄膜炎可能需要全身使用类固醇,但TIN无需使用。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验