A Case of Systemic Sarcoidosis Presenting with Renal Involvement Caused by Various Sarcoidosis-associated Pathophysiological Conditions

Sayo Ueda; Taichi Murakami; Hirokazu Ogino; Motokazu Matsuura; Masanori Tamaki; Seiji Kishi; Mike Hann; Yuko Toyoda; Kojiro Nagai; Yoshimi Bando; Hideharu Abe; Yasuhiko Nishioka; Toshio Doi

doi:10.2169/internalmedicine.1558-18

This article has now been updated. Please use the final version.

A Case of Systemic Sarcoidosis Presenting with Renal Involvement Caused by Various Sarcoidosis-associated Pathophysiological Conditions

Sayo Ueda, Taichi Murakami, Hirokazu Ogino, Motokazu Matsuura, Masanori Tamaki, Seiji Kishi, Mike Hann, Yuko Toyoda, Kojiro Nagai, Yoshimi Bando, Hideharu Abe, Yasuhiko Nishioka, Toshio Doi

Author information

Sayo Ueda
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Taichi Murakami
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Hirokazu Ogino
Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Motokazu Matsuura
Department of nephrology, Tokushima Red Cross Hospital, Japan
Masanori Tamaki
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Seiji Kishi
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Mike Hann
Department of the Directorate for Medical Services, US Navy Hospital, Japan
Yuko Toyoda
Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Kojiro Nagai
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Yoshimi Bando
Division of Pathology, Tokushima University Hospital, Japan
Hideharu Abe
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Yasuhiko Nishioka
Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Japan
Toshio Doi
Department of Nephrology, Graduate School of Biomedical Sciences, Tokushima University, Japan

Keywords: sarcoidosis, granulomatous interstitial nephritis, immunohistochemistry, hypercalcemia, nephrosclerosis

JOURNAL OPEN ACCESS Advance online publication

Article ID: 1558-18

DOI https://doi.org/10.2169/internalmedicine.1558-18

The final version of this article is now available: Vol. 58 (2019), No. 5 pp. 679-684

Details

Abstract

A 61-year-old man was diagnosed with sarcoidosis involving the lungs, eyes, parotid gland and extrathoracic lymph nodes complicated by chronic kidney injury and hypercalcemia. Kidney biopsy showed non-specific interstitial nephritis and nephrosclerosis. However, immunohistochemical staining of cell surface markers revealed a multinucleated giant macrophage surrounded by T-cells, suggesting granulomatous interstitial nephritis. Corticosteroid improved the kidney function, and reduced the serum levels of calcium and angiotensin-converting enzyme. Sarcoid nephropathy may be caused by the combination of several sarcoidosis-associated pathophysiological conditions and a comprehensive kidney examination should be performed to assess the type of injury when determining a treatment strategy.

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