Clinical and pathological analysis of nine renal sarcoidosis

Abstract

Objective To analyze the clinical and pathological features of nine patients of sarcoidosis with renal involvement. Methods The clinical and pathological features and therapeutic results of nine patients of sarcoidosis with renal involvement diagnosed from 2005 to 2015 were analyzed retrospectively. Results ① There were 6 males and 3 females, aged 23-70 years old. Eight cases were diagnosed by renal biopsy, another was by extra lymph nodes biopsy. ② Renal involvement in all cases showed renal tubular injury with elevated serum creatinine, renal glycosuria was found in 5 cases, hypercalcemia in 6 cases, and kidney stone in 4 cases. Extra renal involvements with lymph nodes and lung were common, followed with skin and eye.③Pathological features: 8 cases with renal biopsy showed interstitial nephritis, of which 6 cases can be seen granuloma. ④Treatment and outcomes: all patients were given glucocorticoid.The initial prednisone dose was 30 mg/d. Four cases received 1.5 g/d methylprednisolone for 3 days. After 1 month of treatment, eGFR improved significantly. Serum creatinine returned to normal level in 1 case and none progressed to end stage renal disease. Conclusions The clinical manifestation of renal sarcoidosis includes renal insufficiency, tubule dysfunction and hypercalcemia, and the pathological manifestation is interstitial nephritis with non-caseous granuloma. Given glucocorticoid is effective. Key words: Sarcoidosis; Kidney