Síndrome de Nefrite Túbulo-Intersticial: Revisão Sistemática

Autores

  • Joana Pereira Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  • Paulo Freitas-da-Costa 1- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; 2 - Centro Hospitalar Universitário de São João, Porto, Portugal; 3 - Departamento de Oftalmologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  • Luís Figueira 1- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; 2 - Centro Hospitalar Universitário de São João, Porto, Portugal; 3 - Departamento de Oftalmologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

DOI:

https://doi.org/10.48560/rspo.26970

Palavras-chave:

Nefrite Intersticial, Síndrome, Uveíte

Resumo

INTRODUÇÃO: A síndrome de nefrite e uveíte túbulo-intersticial é uma doença rara caracterizada pela ocorrência de nefrite túbulo-intersticial e uveíte, na ausência de outra doença sistêmica explicável. Nesta revisão pretendemos avaliar e esclarecer o que é reconhecido para elucidar os dados demográficos, a predisposição genética, os sintomas e achados laboratoriais mais frequentes, o tratamento mais adequado e também o prognóstico do paciente.

MÉTODOS: Foi realizada uma revisão sistemática na PubMed, Web of Science e Scopus, de acordo com as diretrizes PRISMA, de forma a identificar todos os artigos relevantes sobre nefrite túbulo-intersticial e uveíte.

RESULTADOS: Identificamos 240 publicações, das quais 176 foram excluídas. A idade média do diagnóstico da síndrome de nefrite e uveíte túbulo-intersticial foi de 30,6 anos, com predomínio do sexo feminino (2:1); De acordo com a apresentação, a nefrite túbulo-intersticial precede os sintomas de uveíte mais comumente e entre os casos de uveíte a maioria foi de uveíte anterior bilateral. Além disso, os sintomas sistêmicos mais comuns foram fadiga, febre e perda de peso; as análises sanguíneas comumente apresentaram elevação da creatinina sérica, da velocidade de hemossedimentação, da proteína C reativa, e do nível de nitrogênio ureico no sangue, na avaliação urinária frequentemente apresentaram proteinúria, glicosúria e a β2-microglobulina urinária elevada. A maioria (78,8%) dos pacientes recebeu corticoide, sendo que 21,9% necessitaram de um imunossupressor adicional, sendo o micofenolato de mofetil (29,8%) e a azatioprina (28,0%) os preferidos. O tempo médio até a recidiva, que ocorreu em 48,3% dos pacientes, foi de 89,3 dias.

CONCLUSÃO: Síndrome de nefrite e uveíte túbulo-intersticial já não é uma síndrome pediátrica, como se pensava. A apresentação parece ser variável, embora a nefrite túbulo-intersticial geralmente se apresente primeiro, associado a sintomas sistêmicos, como fadiga. À medida que os clínicos se tornam mais conscientes da doença, após a identificação do primeiro sintoma, os pacientes são acompanhados, porém, são necessários mais estudos para identificar o tempo de seguimento mais adequado. Relativamente ao tratamento, a maioria dos doentes respondeu aos corticosteroides, e apesar das recorrências, o prognóstico, foi no cômputo geral, favorável.

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Publicado

2022-09-30

Como Citar

Pereira, J., Freitas-da-Costa, P., & Figueira, L. (2022). Síndrome de Nefrite Túbulo-Intersticial: Revisão Sistemática. Revista Sociedade Portuguesa De Oftalmologia, 46(3), 160–175. https://doi.org/10.48560/rspo.26970

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