{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:44:59Z","timestamp":1765536299905,"version":"3.48.0"},"reference-count":15,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,15]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2024-263098","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:40:11Z","timestamp":1765536011000},"page":"e263098","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tubulointerstitial nephritis and uveitis syndrome: an unexpected diagnosis"],"prefix":"10.1136","volume":"18","author":[{"given":"Richard","family":"Farnan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital Galway, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Leavey","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital Waterford, Waterford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Stokes","sequence":"additional","affiliation":[{"name":"University Hospital Waterford, Waterford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital Waterford, Waterford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"2025121202400781000_18.12.e263098.1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(75)90390-3"},{"key":"2025121202400781000_18.12.e263098.2","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1038\/s41433-021-01677-w","article-title":"Tubulointerstitial nephritis and uveitis in Northern Ireland","volume":"36","author":"Heaney","year":"2022","journal-title":"Eye (Lond)"},{"key":"2025121202400781000_18.12.e263098.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(01)00261-2"},{"key":"2025121202400781000_18.12.e263098.4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.104.2.314"},{"key":"2025121202400781000_18.12.e263098.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314926"},{"key":"2025121202400781000_18.12.e263098.6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(81)90408-3"},{"key":"2025121202400781000_18.12.e263098.7","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09051209"},{"key":"2025121202400781000_18.12.e263098.8","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/tan.12116","article-title":"HLA associations with tubulointerstitial nephritis with or without uveitis in Finnish pediatric population: a nation-wide study","volume":"81","author":"Per\u00e4saari","year":"2013","journal-title":"Tissue Antigens"},{"key":"2025121202400781000_18.12.e263098.9","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/ICU.0000000000000421","article-title":"Tubulointerstitial nephritis and uveitis","volume":"28","author":"Pakzad-Vaezi","year":"2017","journal-title":"Curr Opin Ophthalmol"},{"key":"2025121202400781000_18.12.e263098.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(00)00482-7"},{"key":"2025121202400781000_18.12.e263098.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2005.04.019"},{"key":"2025121202400781000_18.12.e263098.12","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.02-0376"},{"key":"2025121202400781000_18.12.e263098.13","doi-asserted-by":"publisher","DOI":"10.1089\/jir.2008.0027"},{"key":"2025121202400781000_18.12.e263098.14","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02370310"},{"key":"2025121202400781000_18.12.e263098.15","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-019-1277-2","article-title":"Effect of steroids and relevant cytokine analysis in acute tubulointerstitial nephritis","volume":"20","author":"Yun","year":"2019","journal-title":"BMC Nephrol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:40:11Z","timestamp":1765536011000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":15,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2024-263098"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263098","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}