{
  "abstract": "A male in his 50s presented to the renal department with a diagnostic challenge of an unexplained kidney injury. Antiphospholipid antibody syndrome and oral anticoagulation augmented the risk for a renal biopsy. This, along with relatively static estimates of glomerular filtration rate combined to delay renal biopsy and definitive renal diagnosis by 6 months. The late emergence of symptomatic bilateral anterior uveitis consolidated the diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome but it also highlighted a lack of systemic early screening for ocular disease in the renal clinic. When faced with a diagnostic challenge, clinicians are more likely to find clinical conditions they are actually looking for. Increased awareness of TINU, earlier screening for ocular symptoms at presentation and/or examination for asymptomatic uveitis when a diagnosis of tubulointerstitial nephritis is being considered is recommended. Furthermore, early screening in cases of bilateral anterior uveitis for existing kidney issues should be pursued.",
  "authors": [
    {
      "affiliations": [
        "Department of Ophthalmology, University Hospital Galway, Galway, Ireland"
      ],
      "name": "Richard Farnan"
    },
    {
      "affiliations": [
        "Department of Nephrology, University Hospital Waterford, Waterford, Ireland"
      ],
      "name": "Sean Leavey"
    },
    {
      "affiliations": [
        "University Hospital Waterford, Waterford, Ireland"
      ],
      "name": "John Stokes"
    },
    {
      "affiliations": [
        "Department of Nephrology, University Hospital Waterford, Waterford, Ireland"
      ],
      "name": "Rob Casey"
    }
  ],
  "title": "Tubulointerstitial nephritis and uveitis syndrome: an unexpected diagnosis",
  "uid": "4b85160c-7b56-5871-9bd7-118ad31d07ff"
}