A Rare Cause of Focal Segmental Glomerulosclerosis: Sarcoidosis

Abstract

A 58-year-old female patient diagnosed as having sarcoidosis 23 years ago developed nephrotic syndrome. No pathology was found which could explain this, so it was attributed to her sarcoidosis. Renal biopsy showed global and segmental sclerosis. The occurrence of focal segmentary glomerulosclerosis in a case of sarcoidosis is rare. In systemic sarcoidosis it is thought that T-cell dysfunction may play a role in the pathogenesis of glomerulonephritis. When treatment is considered, corticosteroid therapy may be used according to the clinical status at diagnosis as well as on follow-up of the patient.

Actinic Granuloma with Focal Segmental Glomerulosclerosis

“…Diabetes mellitus has been found in about 37–40% of patient with AG, and may be caused by injury of elastic fiber from hyperglycemic state [ 12 ]. As for the renal condition, focal segmental glomerulosclerosis has been described in association with various granulomatous diseases (e.g., sarcoidosis, Wegener's granulomatosis, Churg-Strauss syndrome, and Kimura's disease) [ 13 , 14 , 15 , 16 ]. However, the association of AG and focal segmental glomerulosclerosis has never been reported.…”

Renal replacement therapy in sarcoidosis

“…Granulomatous interstitial nephritis is often clinically silent and but may be complicated and lead to end stage kidney disease (ESKD) if not diagnosed or detected too late. Sarcoidosis-associated glomerular diseases, including focal and segmental glomerulosclerosis ( 47 ), IgA nephropathy ( 48 ), and membranous nephropathy ( 49 ) may also progress to ESKD. In a retrospective study of 2009, The French Sarcoidosis Group described 47 adults with renal sarcoidosis and reported that more than 60% of them had a GFR <60 ml/min per 1.73 m 2 and two patients needed hemodialysis after a median follow-up of 24 months ( 50 ).…”