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Isolated Renal Relapse of Sarcoidosis under Low-Dose Glucocorticoid Therapy

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Abstract

Sarcoidosis is a multisystem disease of unknown etiology. Renal manifestation is rare and usually caused by hypercalcemia and nephrocalcinosis. Moreover, renal disease can occur as granulomatous interstitial nephritis (GIN), which is a histological diagnosis. We describe a case of sarcoidosis first presenting with multiple organ involvement including renal failure caused by severe GIN and subsequent remission on glucocorticoid therapy. After 18 months under low-dose prednisolone, the patient was readmitted with acute renal failure, histologically confirmed to be a relapse of renal sarcoidosis. Extrarenal manifestations of sarcoidosis were not present. Glucocorticoid dose was raised and kidney function again recovered significantly. Usual serologic markers of disease activity were not appropriate to indicate disease activity. Renal manifestation of sarcoidosis should be diagnosed by renal biopsy to guide therapy and probably requires larger glucocorticoid doses and prolonged treatment to prevent relapse.

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Acknowledgments

Renal biopsies and CT scans were published by courtesy of Prof. Dr. U. Helmchen, Institute of Pathology, University of Hamburg and Prof. Dr. T. Kahn, Department of Radiology, University of Leipzig.

Potential Financial Conflicts of Interests

None disclosed.

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Authors and Affiliations

  1. Department of Medicine, University of Leipzig, Leipzig, Germany

    Christof Mayer MD, Angela Müller MD, Jan Halbritter MD & Michael Stumvoll MD

  2. Department of Respiratory Medicine, University of Leipzig, Leipzig, Germany

    Hubert Wirtz MD

  3. Philipp-Rosenthal, Leipzig, Germany

    Michael Stumvoll MD

Authors
  1. Christof Mayer MD
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  2. Angela Müller MD
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  3. Jan Halbritter MD
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  4. Hubert Wirtz MD
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  5. Michael Stumvoll MD
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Correspondence to Michael Stumvoll MD.

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Mayer, C., Müller, A., Halbritter, J. et al. Isolated Renal Relapse of Sarcoidosis under Low-Dose Glucocorticoid Therapy. J GEN INTERN MED 23, 879–882 (2008). https://doi.org/10.1007/s11606-008-0603-3

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  • DOI: https://doi.org/10.1007/s11606-008-0603-3

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