Acute kidney injury caused by sarcoid granulomatous interstitial nephritis without extrarenal manifestations

CEN Case Reports
Hiroaki KikuchiShinichi Uchida

Abstract

Granulomatous interstitial nephritis (GIN) is one of the renal pathological manifestations of sarcoidosis. It is usually clinically silent, but may present occasionally as acute kidney injury (AKI). AKI caused by sarcoid GIN without extrarenal manifestations is extremely rare. We report a case of a 70-year-old man with a history of type 2 diabetes mellitus admitted with progressively worsening kidney function. The patient also exhibited anorexia, malaise and weight loss. Laboratory tests showed an elevated serum lysozyme level, but the serum angiotensin-converting enzyme (ACE) and serum calcium levels were normal. Increased uptake was evident only in kidney on gallium 67 scintigraphy. Although typical organ involvement of sarcoidosis was not evident, a renal biopsy showed granulomatous interstitial nephritis with non-caseating granulomas. No medications had been added in the 3 years preceding renal function deterioration. Following a bronchoalveolar lavage that revealed a high CD4:CD8 ratio, and a skin test that showed negative for tuberculin, a diagnosis of renal sarcoidosis was established. On diagnosis, oral prednisolone was initiated and renal function improved. The anorexia and malaise also disappeared. This is the extreme...Continue Reading

References

Aug 1, 1978·Postgraduate Medical Journal·E T MacSearraighD J O'Sullivan
Jan 1, 1990·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·T HannedoucheP Jungers
Jun 1, 1980·Journal of Clinical Pathology·P R StuddyD G James
Dec 1, 1995·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·J M CruzadoJ Alsina
Aug 1, 1993·Chest·R H WinterbauerS C Springmeyer
Dec 31, 1997·Clinics in Chest Medicine·D G James
Dec 6, 2001·American Journal of Respiratory and Critical Care Medicine·R P BaughmanUNKNOWN Case Control Etiologic Study of Sarcoidosis (ACCESS) research group
Jan 25, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Michael G RobsonHugh S Cairns
Jun 26, 2003·JAMA : the Journal of the American Medical Association·Karl W Thomas, Gary W Hunninghake
Jul 24, 1954·Lancet·C HOYLEG MATHER
Oct 14, 2004·Clinical and Experimental Nephrology·Ken-ichi MiyoshiJitsuo Higaki
Jul 20, 2006·Clinical Rheumatology·M Mubashir AhmedNeville R Dossabhoy
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Nicola JossColin Geddes
Dec 20, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Varun AgrawalBenjamin J Freda
Mar 6, 2013·Clinical Nephrology·Shinichiro IkedaTaichi Nakamura
Apr 25, 2014·Avicenna Journal of Medicine·Azam Ghafoor, Akram Almakki

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Citations

Jul 3, 2018·Current Opinion in Pulmonary Medicine·Raoul Bergner, Christian Löffler
Aug 18, 2020·Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Fatima S AlangariNourah Aloudah
Sep 7, 2017·Clinical Rheumatology·Wenfang DongLeren He
Apr 16, 2020·Journal of Clinical Medicine·Rashi JainJun-O Jin

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