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FOAAD
Although the tubules and the interstitium are distinct functional entities, they are
intimately related.
15% are idiopathic and 5% are cases of tubulointerstitial nephritis with uveitis
(TINU) syndrome.
Patients present with fever, arthralgia, skin rashes and acute oliguric or non-
oliguric renal failure. Many have eosinophilia and eosinophiluria.
Rarely, NSAIDs can cause a glomerular minimal change lesion in addition to TIN
and present as the nephrotic syndrome.
Patients may require dialysis for management of the acute renal failure.
Most patients make a good recovery in the kidney function, but some may be left
with significant interstitial fibrosis and a persistent high serum creatinine.
TIN can complicate systemic infections with viruses( hantavirus, EBV, HIV,
measles, adenovirus),
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bacteria(Legionella,leptospira,streptococci,Mycoplasma,Brucella,Chlamydia) and
others ( Leishmania, Toxoplasma).
TINU syndrome
Among adults it is more common in females, but its cause remains unknown.
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Chronic tubulointerstitial nephritis
Causes are:
Common Uncommon
DM Irradiation
Trait
intoxication.
The patient usually either presents with polyuria and nocturia ,or is found to have
proteinuria or uraemia.
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Papillary necrosis with ischemic changes to the papillae occurs in a number of
tubulointerstitial nephritidis,e.g., analgesic abuse,DM,sickle cell disease or trait
Analgesic nephropathy
Tension headace
This may result in the arrest of the disease and even improvement in the function.
UTI ,hypertension (if presents) and saline depletion will require appropriate
management.
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