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Systemic Sarcoidosis Presenting With Hypercalcemia, Acute Kidney Injury, and Diffuse Lymphadenopathy: Unlocking

Virginia Geladari¹, Paraskevi Liaveri², Georgios Liapis³

¹1st Department of Internal Medicine, General Hospital of Trikala, Trikala, GRC.

|June 16, 2025

Summary

Sarcoidosis can affect kidneys, presenting as acute kidney injury with hypercalcemia. Early diagnosis and treatment with corticosteroids and hydroxychloroquine improve kidney function.

Keywords:

acute kidney injury granulomatous interstitial nephritis hypercalcemia renal sarcoidosis sarcoidosis

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Area of Science:

Nephrology
Rheumatology
Internal Medicine

Background:

Sarcoidosis is a multisystem granulomatous disease with varied presentations.
Renal involvement in sarcoidosis is rare, particularly without extra-renal signs, complicating diagnosis.

Observation:

A 58-year-old female presented with acute kidney injury, hypercalcemia, lymphadenopathy, and B symptoms.
Lab results showed elevated creatinine, calcium, calcitriol, and angiotensin-converting enzyme (ACE), with suppressed intact parathyroid hormone (iPTH).

Findings:

Renal biopsy confirmed granulomatous interstitial nephritis (sGIN), consistent with sarcoidosis.
Treatment with corticosteroids and hydroxychloroquine led to significant recovery of kidney function.

Implications:

This case highlights the importance of considering sarcoidosis in patients with unexplained acute kidney injury and hypercalcemia.
Early recognition and intervention are crucial for managing renal sarcoidosis and preventing irreversible kidney damage.