Ben Kaab Badreddine (Tunisia)
Rabta hospital NephrologyAuthor of 1 Presentation
RENAL INVOLVEMENT IN SARCOIDOSIS: REVIEW OF SIX CASES AT ONE CENTER
Abstract
Background and Aims
Sarcoidosis is an idiopathic multisystem granulomatous disease.Renal involvement in sarcoidosis is rare.It is usually due to abnormal calcium balance or parenchymal involvement.The aim of our study was to analyze the epidemiologic,clinical,paraclinical,therapeutic features and the outcome of sarcoidosis in patients with renal manifestations.
Methods
We carried a descriptive retrospective study including 6 patients with sarcoidosis,hospitalized in the nephrology department of Rabta Hospital of Tunis between 2012 and 2018.Renal biopsy was performed for all patients.
Results
Our series involved 5 women and one man with a mean age of 41.6 years.All patients presented with renal failure on admission.Laboratory tests showed normal calcium levels in five cases.One patient had hypercalcemia.Hypercalciuria was noted in one case.The angiotensin-converting enzyme was measured in 3 cases and it was normal.Extra-renal manifestations were:pulmonary interstitial syndrome(4 cases),anterior granulomatous uveitis(2 cases),cutaneous lesions(2 cases),cardiac sarcoidosis(one case),neurosarcoidosis(one case),hepatic sarcoidosis(one case),parotid gland sarcoidosis(one case)and polyarthritis(one case).Kidney biopsy showed granulomatous interstitial nephritis in five patients while the other patient had crystal nephropathy associated to interstitial nephritis without granuloma.All patients initially received oral prednisolone(1 mg/kg/day) with subsequent tapering.One patient was treated with inhaled corticosteroids for diffuse parenchymal lung involvement and two patients were put on immunosuppressive therapy (Azathioprine).No patient required dialysis.After a mean follow-up of 57 months,the outcome was marked by the improvement of serum creatinine in 4 patients,in whom one patient showed a new recurrence of renal sarcoidosis.Two patients reached end-stage renal disease.
Conclusions
Renal involvement is rare in sarcoidosis.Early diagnosis with appropriate treatment must be set early in order to prevent progression to chronic renal failure.