Isolated Renal Sarcoidosis Presenting with Granulomatous Interstitial Nephritis: A Case Report and Review of the LiteratureYoichiro Chikamatsu1, Izaya Nakaya1, Mayumi Yahata1, Hiroyo Sasaki1, Kazuhiro Yoshikawa1, Tsutomu Sakuma2 and Jun Soma1*
- *Corresponding Author:
- Department of Nephrology
Iwate Prefectural Central Hospital
1-4-1 Ueda, Morioka, Iwate 020-0066, Japan
E-mail: [email protected]
Received Date: February 05, 2014; Accepted Date: March 22, 2014; Published Date: March 27, 2014
Citation: Chikamatsu Y, Nakaya I, Yahata M, Sasaki H, Yoshikawa K, et al. (2014) Isolated Renal Sarcoidosis Presenting with Granulomatous Interstitial Nephritis: A Case Report and Review of the Literature. J Nephrol Therapeutic S1:008 doi: 10.4172/2161-0959.S1-008
Copyright: © 2014 Chikamatsu Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Sarcoidosis is a multi-system disorder characterized by noncaseating epitheloid granuloma in multiple organs. However, granulomatous interstitial nephritis in the absence of extrarenal renal lesions is very rare.
Case presentation: A 64-year-old male presented with a weight loss of 10 kg and an increase in serum creatinine from 1.1 to 4.8 mg/dl over a 1-year period. At admission, no proteinuria or hematuria was found, although serum creatinine was 5.1 mg/dl and was associated with slight increases in serum angiotensin converting enzyme and calcium levels. Renal biopsy revealed granulomatous interstitial nephritis with noncaseating epitheloid cells. The patient was diagnosed with sarcoidosis, although no extrarenal sarcoid lesion was found. Oral prednisolone was effective, with normalization of serum creatinine levels 2 weeks later. A review of the literature showed that isolated granulomatous renal sarcoidsosis preferentially affected elderly males, and their serum angiotensin converting enzyme levels were normal or mildly increased in many cases.
Conclusions: This paper describes a rare case of isolated renal sarcoidosis with acute granulomatous interstitial nephritis. This case and a relevant review of the literature demonstrate that sarcoid granulomatous interstitial nephritis should be considered as one of differential diagnoses in elderly male patients with suspected tubulointerstitial nephritis irrespective of angiotensin converting enzyme levels.