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Interstitial nephritis in sarcoidosis: simultaneous multiorgan involvement
J M Cruzado1, R Poveda, J Mañá
1Department of Nephrology, Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Summary
This study highlights two sarcoidosis cases with kidney involvement (interstitial nephritis) and widespread disease. Steroid treatment improved kidney function, showing early intervention is key for sarcoidosis patients.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas.
- Interstitial nephritis is a recognized, though less common, renal manifestation of sarcoidosis.
- Simultaneous renal and extrarenal involvement in sarcoidosis-associated interstitial nephritis is infrequently reported.
Observation:
- Two patients presented with sarcoidosis exhibiting simultaneous renal failure and multiple extrarenal manifestations, including bone marrow granulomas.
- Initial gallium-67 scintigraphy of the kidneys yielded negative results in both patients.
- Histopathological examination revealed lymphocytic interstitial nephritis in one patient and granulomatous interstitial nephritis in the other.
Findings:
- Steroid therapy led to complete renal function recovery in the patient with lymphocytic interstitial nephritis within one year.
- The patient with granulomatous interstitial nephritis showed improved renal function, with a follow-up biopsy indicating granuloma resolution and residual fibrosis.
- These cases demonstrate that interstitial nephritis in sarcoidosis can coexist with significant multiorgan disease.
Implications:
- The findings suggest that negative gallium-67 renal scans do not exclude active kidney involvement in sarcoidosis.
- Early diagnosis and prompt steroid treatment are crucial for managing sarcoidosis-associated interstitial nephritis and improving renal outcomes.
- This study underscores the importance of considering renal involvement in sarcoidosis patients presenting with systemic symptoms and renal dysfunction.