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儿童肾小管间质性肾炎和葡萄膜炎综合征:三例报告

Tubulointerstitial nephritis and uveitis syndrome in children: report of three cases.

作者信息

Pereira Cátia, Gil Joana, Leal Inês, Costa-Reis Patrícia, Silva José Eduardo Esteves Da, Stone Rosário

机构信息

Serviço de Pediatria Médica, Departamento de Pediatria, Hospital de Santa Maria, Centro Académico de Medicina, Universidade de Lisboa, Lisboa, Portugal.

Serviço de Oftalmologia, Hospital de Santa Maria, Centro Académico de Medicina, Universidade de Lisboa, Lisboa, Portugal.

出版信息

J Bras Nefrol. 2018 Jul-Sep;40(3):296-300. doi: 10.1590/2175-8239-jbn-2018-0015. Epub 2018 Jun 18.

Abstract

Tubulointerstitial nephritis and uveitis syndrome is a rare and probably underdiagnosed condition. Renal and ocular manifestations may not occur simultaneously, making the diagnosis more difficult. Nephritis may be asymptomatic; therefore, renal function evaluation is essential for diagnosis. Urinary β2-microglobulin levels may be particularly useful. Uveitis, mostly anterior, nongranulomatous and bilateral, occurs usually after the onset of nephritis. Treatment includes corticosteroids and, eventually, other immunosuppressant agents. Renal disease is usually benign and resolves spontaneously or after treatment with systemic corticosteroids. Uveitis, however, may be chronic or recurrent. The authors described the cases of three pediatric patients diagnosed with tubulointerstitial nephritis and uveitis syndrome. The goal of this paper was to warn the medical community over the need to screen patients with uveitis for renal disease.

摘要

肾小管间质性肾炎与葡萄膜炎综合征是一种罕见且可能未被充分诊断的疾病。肾脏和眼部表现可能不同时出现,这使得诊断更加困难。肾炎可能无症状;因此,肾功能评估对诊断至关重要。尿β2-微球蛋白水平可能特别有用。葡萄膜炎大多为前部、非肉芽肿性且双侧性,通常在肾炎发病后出现。治疗包括使用糖皮质激素,最终可能还需使用其他免疫抑制剂。肾脏疾病通常为良性,可自发缓解或经全身糖皮质激素治疗后缓解。然而,葡萄膜炎可能是慢性的或复发性的。作者描述了3例被诊断为肾小管间质性肾炎与葡萄膜炎综合征的儿科患者病例。本文的目的是提醒医学界有必要对葡萄膜炎患者进行肾脏疾病筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15b0/6533956/6ea178ae8406/2175-8239-jbn-2018-0015-gf01.jpg

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