Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.

Os efeitos sociais e psicológicos da doença, bem como as suas debilidades altamente visíveis e suas sequelas, resultaram em um estigma histórico associado à hanseníase (BAIALARDI, 2007). RELATO DE CASO: Descrevemos o caso de uma paciente de 75 anos de idade, tratada de hanseníase e que apresenta como sequela o mal perfurante plantar, que a incapacita de exercer suas atividades de trabalho. DISCUSSÃO: O mal perfurante plantar é decorrente da lesão do nervo tibial posterior, que, quando atingido, promove perda da sudorese e sensibilidade na região anterior da plana do pé (AZULAY, 2008). CONCLUSÃO: O diagnóstico e o tratamento precoces são fundamentais para evitar as incapacidades e permitir que o indivíduo portador da doença volte a ser inserido no mercado de trabalho, o que contribui para sua inclusão social.