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題名:ADULT ONSET TUBULOINTERSTITIAL NEPHRITIS AND UVEITIS SYNDROME--A CASE REPORT     (12點)
腎小管間質腎炎與葡萄膜炎症候群--病例報告
著者:Hao-Chen Chang(張皓程) ;Chun-Chen Chen(陳純貞) ;Hung-Yen Chen(陳宏彥) ;Shiow-Wen Liou(劉秀雯) ;Lin-Chung Woung(翁林仲)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:tubulointerstitial nephritis ; uveitis ; optic disc edema ; corticosteroid
刊名:中華民國眼科醫學會雜誌
卷期:47卷4期(2008.12)
頁碼:443-448
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:我們報告一名有腎臟切片確認之腎小管間 質腎炎與葡萄膜炎症候群病例。 方法:病例報告。 結果:一位29 歲有三次前葡萄膜炎發作病史的 男性,主訴左眼無痛性視力模糊約一週,同時間出現 兩側下肢水腫。到院時右眼最佳矯正視力20/20 '左 眼最佳矯正視力20/40 。眼底檢查發現雙眼前房皆有 發炎反應。尿液分析發現有蛋白尿,血清有大幅上升 之血尿素氮和肌酸酌,顯示為急性腎衰竭發作。經皮 腎臟切片之病理檢查發現急,性腎小管間質腎炎,證實為腎小管間質腎炎與葡萄膜炎症候群(tubulointerstitial nephritis and uveitis syndrome) 。病患使用局部及全 身性類固醇五個月後,葡萄膜炎消失,左眼視力回復 到20120 。 結論:腎小管間質腎炎與葡萄膜炎症候群是造成 葡萄膜炎的病因中,可能被輕忽的一個疾病。眼科醫 師在腎小管間質腎炎與葡萄膜炎症候群的診斷上扮 演重要的第一線角色。在面對葡萄膜炎時進行完整的 內科評估,將有助於發現病因並做出正確的治療計 畫。
Purpose: To repo叫a case of biopsy-proven tubulointerstitial nephritis and uveitis (TINU) syndrome involving the posterior segment. Method: Case repo付. Results: A 29-year-old male had suffered from painless blurred vision in the left eye for one week. The patient had the history of bilateral anterior uveitis. Initially, his best spectacle corrected visual acuity (BSCVA) was 20/20 in the right eye and 20/40 in the left eye. The ocular examination revealed cells and flares in the bilateral anterior chambers. Fundus examination showed macular exudates, intraretinal hemorrhage, sheathing of retinal vessels, and optic disc edema. Laboratory tests revealed elevated serum creatinine (3.8 mg/dl) and blood urea nitrogen (BUN) (48.3 mg/dl). Percutaneous renal biopsy showed acute tubulointerstitial nephritis. In addition, we excluded other diseases which can cause both acute nephritis and uveitis, such as Sj凸gren syndrome, Behçet's disease and systemic lupus erythematosus (SLE). The diagnosis of tubulointerstitial nephritis and uveitis syndrome was established. The patient was treated with topical prednisolone and cycloplegics. Intravenous pulse therapy of methylprednisolone (1 gm daily) was also given for three days, followed by oral prednisolone 60 mg daily. Ocular inflammation and optic disc edema in both eyes were resolved and BSCVA of 20/20 was achieved in the left eye after six-month follow-up. Conclusion: TINU syndrome is probably an under-diagnosed cause of uveitis. Ophthalmologists play an impo 內ant role in the initial discovery of patients with TINU syndrome. A thorough medical evaluation of any patient presenting with uveitis and systemic disease is crucial to early diagnosis and appropriate management.


    

本卷期目次
中華民國眼科醫學會雜誌 47卷4期 (2008.12)
小兒葡萄膜炎:診斷與治療原則/ 林耕國黃奕修
治療葡萄膜炎免疫抑制藥物依實證醫學的使用原則:至2008年相關文獻回顧 第一部份:類固醇在葡萄膜炎的使用原則/ 黃奕修賴旗俊
INTRAVITREAL BEVACIZUMAB (AVASTIN) FOR CHOROIDAL NEOVASCULARIZATION SECONDARY TO PATHOLOGIC MYOPIA: A SHORT TERM RESULT/ Kai-Han HuangCheng-Kuo ChengChi-Hsien PengTong-Sheng LeeChao-Chen HuTzu-En WuHui-Chen LinPai-Hui Peng
IOL REPLACEMENT IN PSEUDOPHAKIC CORNEAL EDEMA--TWO CASES REPORT/ Jian-Sheng WuYu-Ling LiuChang-Ping Lin
ENDOPHTHALMITIS CAUSED BY MORGANELLA MORGANII AFTER CATARACT SURGERY/ Ying-Jen ChenPo-Liang ChenChing-Long ChenJiann-Torng Chen
MULTIPLE MYELOMA PRESENTING AS EXOPHTHALMOS AND UNILATERAL CENTRAL RETINAL VEIN OCCLUSION: A CASE REPORT/ Youn-Shen BeeFan-ping ChangChia-Wei ShenChiu-Tung ChuangMuh-Chiou LinShwu-Jiuan Sheu
POST-OPERATIVE INFLAMMATION IN MICROPHTHALMOS--A CASE REPORT/ Yi-An LeeFung-Rong HuI-Jong WangWei-Li ChenYu-Chih Hou
ADULT ONSET TUBULOINTERSTITIAL NEPHRITIS AND UVEITIS SYNDROME--A CASE REPORT/ Hao-Chen ChangChun-Chen ChenHung-Yen ChenShiow-Wen LiouLin-Chung Woung
A CASE REPORT OF ENDOGENOUS ENDOPHTHALMITIS CAUSED BY NON-01/NON-0139 VIBRIO CHOLERAE/ Yu-Chen ChenChiao-Ying LiangHin-Yeung Choi
RECURRENT EPIPHORA AFTER DACRYOCYSTORHINOSTOMY AS AN INITIAL SYMPTOM OF LACRIMAL SAC MALIGNANCY : A CASE REPORT/ Meng-Te ChenLi-Chen WeiHin-Yeung Choi
POSTOPERATIVE SERRATIA MARCESCENS ENDOPHTHALMITIS WITH CHEESY WHITE HYPOPYON--A CASE REPORT AND REVIEW/ Mei-Chin ChenJen-Chieh LinJy-Haw Yu
USING BEVACIZUMAB IN A CASE OF POEMS SYNDROME RELATED BILATERAL OPTIC DISC EDEMA: A CASE REPORT/ Chih-Yuan YangChia-Hung LiChi-Ting HorngShen-Shiung TzengFeng-Chi, LinJiann-Torng Chen
脈絡膜結核肉芽腫之網膜斷層攝影--病例報告/ 林亭君陳勇仁
以翼狀贅肉呈現的結膜鱗狀細胞癌--病例報告/ 夏恆健
 
   
 
   

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