A case of childhood renal sarcoidosis

Abstract

We report a case of 14-year-old boy diagnosed with renal sarcoidosis. The patient was brought to our hospital with fever, but physical examination and the laboratory data did not lead to diagnosis. He was evaluated by contrast-enhanced computed tomography (CT) and CT found multiple low dense areas enhanced less than the adjacent normal renal parenchyma, suggesting interstitial nephritis. As further examination, he was underwent Ga-67 scintigrams, which indicated bilateral renal accumulation. Although the renal function was normal at initiation, serum creatinine level increased progressively (1.65 mg/dL) during follow-up and he was underwent renal biopsy to obtain definitive diagnosis. After ruling out other diseases that develop interstitial nephritis, the diagnosis of sarcoidosis was established on histopathology of granulomatous interstitial nephritis from renal biopsy. The renal function improved shortly after corticosteroid therapy and mycophenolate mofetil were introduced. Treatment is necessary in cases with renal insufficiency, and it should be performed before the interstitial fibrosis progresses into renal failure. In addition, the use of MMF conjunction with corticosteroids might have a steroid-sparing role.