POS-110 RENAL SARCOIDOSIS OCCURING AFTER LYMPHOMA: A CASE REPORT

Abstract

The ‘sarcoidosis-lymphoma syndrome’ as described by Brincker is the onset of a lymphoma several years after the diagnosis of sarcoidosis. However, discovering sarcoidosis months after being treated for lymphoma has rarely been reported. Sarcoidosis is usually diagnosic upon extra-renal symptoms.We report an exceptional case of isolated renal sarcoidosis diagnosed after lymphoma. a case report of renal sarcoidosis in a patient followed for lymphoma. A 60-year-old man monitored atopic disease, gout and prostate adenoma consulted in August 2019 for deterioration of the general condition and a significant weight loss of 35 kg. Clinical examination found an inguinal lymphadenopathy. The biopsy showed a blast variant mantle cell lymphoma. Hence, treatment by Adriblastine Rituximab and Cyclophosphamide was initiated. He received the last dose in February 2020 with a good clinical and radiological response always keeping a normal renal function. In July 2020, the patient suffered epigastralgia and vomiting with balance sheet deterioration of renal function (creatinine at 680 umol / l). He was on examination hemodynamically and respiratory stable with a diuresis at 1.5l / d. Biology showed no fluid electrolyte disturbance, normochromic normocytic anemia at 9.1g / dl, 24 hour proteinuria at 1.76g and Tumor markers were negative. Renal biopsy showed acute interstitial nephritis and non caseous granulomatous in favor of sarcoidosis. Dermatological examination did not show skin lesions. The ophthalomological examination was without abnormalities. Thoraco-abdominal-pelvic CT scan did not show any signs of sarcoidosis. Corticosteroid therapy was initiated at a dose of 1 mg / kg / day with a favorable outcome and improvement in renal function (creatinine from 1042 to 150 µmol /l). The sarcoidosis-lymphoma syndrome classically made up of lymphoma occurring after sarcoidosis may have a reverse chronology.