1Hudde T., 1Heinz C, 2Neudorf U., 1Steuhl K.-P., 3Heiligenhaus A.

1University Eye Hospital Essen, 2University Child Hospital Essen, 3Eye Dept. St.-Franziskus-Hospital Münster

Objective: To describe the clinical course of two TINU patients and compare to descriptions in the medical literature.
Methods: Retrospective case report of two TINU patients seen in the uveitis clinic in Essen (follow up time: 17 and 13 months, respectively) and a Medline research.
Results: Patient 1: An 18 year old woman with known Hashimoto's thyroiditis and nephritis developed cyclitis with papillary and macular edema in both eyes; rapid improvement with systemic and locally applied steroids and acetazolamide therapy; relapse on steroid dose reduction. Patient 2: In a 15 year old girl with marked adiposity and nephritis acute anterior uveitis with posterior synechiae developed in both eyes. Despite improvement with topical steroid application a papillary edema and dense vitreal infiltrates develop. Clinical findings improved without systemic therapy.
Conclusions: TINU syndrome is rare and mainly children and young adults are affected. Anterior uveitis is commonly dissociated from nephritis and may be relapsing or chronic. Locally applied and, if necessary systemic steroids may be sufficient; in the literature some patients received steroid saving immunosuppressive therapy. Patients suffering from this multiorgan disease should be jointly followed up by a pediatrician or a specialist for internal medicine.

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