How Is Tubulointerstitial Nephritis-uveitis Syndrome Diagnosed?

In the medical field, there are many diseases of unknown etiology, which are intractable diseases that medical experts are troubled by. The cause of the disease determines how the disease occurs and allows doctors to diagnose it. Therefore, to know how to treat tubulointerstitial nephritis uveitis syndrome, we must find the cause. There are no satisfactory diagnostic criteria for tubulointerstitial nephritis and uveitis syndrome. Mandeville et al. developed diagnostic criteria that defined the diagnostic criteria for acute interstitial nephritis and the characteristics of uveitis.

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According to the parameters of diagnosis, it is judged as definite tubulointerstitial nephritis uveitis syndrome, suspected tubulointerstitial nephritis uveitis syndrome, and pseudo tubulointerstitial nephritis uveitis syndrome. type. Because this standard is cumbersome, the diagnostic points of this syndrome are listed in Table 3 for clinical reference. It is generally believed that the diagnosis can be made based on the typical manifestations of kidney damage and bilateral non granulomatous anterior uveitis, but sometimes uveitis in patients can appear before or months after kidney damage. This brings some difficulties to the diagnosis. Therefore, not only a detailed medical history but also follow-up observation should be paid to confirm the diagnosis.

Since many patients have systemic non-specific manifestations such as fever, fatigue, nausea and vomiting, weight loss, and abdominal pain, blood and urine tests should be performed for patients with non-granulomatous anterior uveitis in both eyes to avoid delay in diagnosis. However, when a patient has tubulointerstitial nephritis-uveitis syndrome, the symptoms of general nephritis will appear, and misdiagnosis is very easy at this time. After understanding, everyone has a preliminary understanding of tubulointerstitial nephritis and uveitis syndrome, and it is necessary to strengthen their physical fitness to prevent the occurrence of the disease.

How to treat and care for tubulointerstitial nephritis and uveitis syndrome

When treating tubulointerstitial nephritis-uveitis syndrome, two parts of the body are treated separately. Therefore, the treatment process is also more complicated, and people tend to ignore some details during treatment, resulting in repeated attacks of the disease. Therefore, it is necessary to know the specific treatment and nursing of tubulointerstitial nephritis uveitis syndrome. The treatment of idiopathic acute tubulointerstitial nephritis is mainly supportive care and immunosuppressive therapy. It is generally believed that although some patients with severe acute kidney failure require replacement therapy support, most patients with idiopathic AIN have kidney failure spontaneously resolved after supportive treatment, and the prognosis is usually good, especially for children.

In view of the pathogenesis and clinical characteristics of this type of acute tubulointerstitial nephritis, it is suggested that the immune response is involved, and glucocorticoid therapy is often given clinically. Local glucocorticoid treatment can mostly relieve uveitis, and dexamethasone eye drops can be given to the eyes once an hour, and then the frequency of eye drops can be gradually reduced according to the control of inflammation. If eye drops treatment causes increased intraocular pressure, the frequency of eye installation can be adjusted or glucocorticoids with fewer side effects can be used, and anti-glaucoma drug eye installation treatment can be given. Afterward, as the inflammation decreases, the frequency of eyedrops is gradually reduced. You can also choose non-steroidal anti-inflammatory drug eye drops for eye treatment. However, attention should be paid to slow withdrawal of the drug to prevent a recurrence, and local treatment can still be effective for recurrent patients.

For most patients with tubulointerstitial nephritis and uveitis syndrome, systemic glucocorticoid treatment can not only improve kidney function but also prevent the progression of kidney interstitial fibrosis. At present, it is believed that moderate-dose steroid therapy should be used early for patients with severe disease and idiopathic acute tubulointerstitial nephritis with granuloma, and pulse therapy with methylprednisolone can be considered if necessary. If it is ineffective or relapses after drug withdrawal, other immunosuppressive agents (such as cyclophosphamide or cyclosporine, etc.) can be considered for treatment, and satisfactory efficacy can still be obtained, but special attention should be paid to monitoring the side effects of these drugs. Some adult patients do not respond well to hormonal therapy, or TINU syndrome recurs repeatedly, resulting in different degrees of renal damage, but only a very small number (<5%) progress to end-stage renal failure.

Unlike a kidney disease, uveitis is prone to recurrence, and recurrence of anterior uveitis may occur even during systemic glucocorticoid therapy. However, in the vast majority of patients, the inflammation is limited to the anterior segment and is sensitive to local glucocorticoid treatment, so it generally does not cause serious consequences. Complications such as glaucoma affect the visual prognosis of patients. For the treatment of tubulointerstitial nephritis-uveitis syndrome, attention should be paid to the prognosis of nephritis and to prevent the recurrence of nephritis. For uveitis, it is necessary to pay more attention to its treatment process to avoid unnecessary complications caused by inappropriate treatment methods. Patients should actively cooperate with the doctor when receiving treatment.

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