Acute kidney injury with granulomatous interstitial nephritis and vasculitis revealing sarcoidosis

Kâaroud, H.; Boubaker, Karima; Barbouch, S.; Goucha, R.; Hamida, F. Ben; Abdallah, T. Ben

doi:10.4103/1319-2442.215120

Cited by 9 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Systemic vasculitis associated with sarcoidosis has been previously reported. 25 , 26 More recent sporadic case reports have also noted CNS vasculitis on conventional angiography or VWI, albeit in patients presenting with stroke. 27 , 28 Our study, however, documents the extent and distribution of vascular abnormalities in patients with NS without a distinct stroke-like syndrome.…”

Section: Discussionmentioning

confidence: 99%

Vascular Involvement in Neurosarcoidosis

Bathla

Abdel-Wahed

Agarwal

et al. 2021

Neurol Neuroimmunol Neuroinflamm

View full text Add to dashboard Cite

Background and ObjectivesCerebrovascular manifestations in neurosarcoidosis (NS) were previously considered rare but are being increasingly recognized. We report our preliminary experience in patients with NS who underwent high-resolution vessel wall imaging (VWI).MethodsA total of 13 consecutive patients with NS underwent VWI. Images were analyzed by 2 neuroradiologists in consensus. The assessment included segment-wise evaluation of larger- and medium-sized vessels (internal carotid artery, M1-M3 middle cerebral artery; A1-A3 anterior cerebral artery; V4 segments of vertebral arteries; basilar artery; and P1-P3 posterior cerebral artery), lenticulostriate perforator vessels, and medullary and deep cerebral veins. Cortical veins were not assessed due to flow-related artifacts. Brain biopsy findings were available in 6 cases and were also reviewed.ResultsMean patient age was 54.9 years (33–71 years) with an M:F of 8:5. Mean duration between initial diagnosis and VWI study was 18 months. Overall, 9/13 (69%) patients had vascular abnormalities. Circumferential large vessel enhancement was seen in 3/13 (23%) patients, whereas perforator vessel involvement was seen in 6/13 (46%) patients. Medullary and deep vein involvement was also seen in 6/13 patients. In addition, 7/13 (54%) patients had microhemorrhages in susceptibility-weighted imaging, and 4/13 (31%) had chronic infarcts. On biopsy, 5/6 cases showed perivascular granulomas with vessel wall involvement in all 5 cases.DiscussionOur preliminary findings suggest that involvement of intracranial vascular structures may be a common finding in patients with NS and should be routinely looked for. These findings appear concordant with previously reported autopsy literature and need to be validated on a larger scale.

show abstract

Section: Discussionmentioning

confidence: 99%

Vascular Involvement in Neurosarcoidosis

Bathla

Abdel-Wahed

Agarwal

et al. 2021

Neurol Neuroimmunol Neuroinflamm

View full text Add to dashboard Cite

show abstract

“…Two cases of angiocentric granulomatous vasculitis in renal sarcoidosis have been reported previously [ 11 , 12 ]. However, unlike the previous reports, this case report showed various outstanding concomitant findings, such as epithelioid cell arrangement and glomerular and renal vascular lesions.…”

Section: Discussion/conclusionmentioning

confidence: 99%

A Case Demonstrating the Pathological Relationship between Granulomatous Vasculitis and Glomerular Lesion in Renal Sarcoidosis

Kamata

Sato

Sugiura

et al. 2020

Case Rep Nephrol Dial

View full text Add to dashboard Cite

We experienced a rare case of tubulointerstitial angiocentric granulomatous vasculitis with focal segmental glomerulosclerosis (FSGS) and associated sarcoidosis. Our patient was an 18-year-old man who presented with exertional cough and dyspnea. He also had overt proteinuria (3.0 g/24 h), normal renal function (eGFR 95 mL/min/1.73 m<sup>2</sup>), heart failure, and hypertension. He had no previous episode of hypertension. These manifestations immediately improved after the administration of antihypertensive therapy that contained an angiotensin-converting enzyme inhibitor, calcium antagonists, beta antagonists, and diuretics. However, he, later on, developed renal dysfunction, with worsening of both proteinuria and hypertension. Renal biopsy was performed and showed epithelioid cells that were arranged concentrically around small blood vessels in tubulointerstitial granulomas. In the glomeruli, the segmental sclerotic lesions were classified as a perihilar variant of FSGS. There were no inflammatory changes, such as a mesangial lesion, inflammatory cell infiltration, fibrinoid necrosis, or crescent formation, and no glomerular granuloma. In the tubulointerstitial granulomas, the intimal elastic lamina of the interlobular arteries was reduplicated, and the intimal wall thickness of renal arterioles was remarkable. After receiving oral prednisolone therapy, the overt proteinuria resolved, the eGFR recovered from 39.4 to 60.6 mL/min/1.73 m<sup>2</sup>, and hypertension was managed more easily. Thereafter, he did not experience any recurrence. The concurrent improvement of renal function and proteinuria by steroid treatment suggested a relationship between the glomerular lesions and the tubulointerstitial granulomatous vasculitis with associated sarcoidosis.

show abstract

“…Granulomatous inflammation can be observed in various conditions such us infections, lymphoma, or granulomatous with polyangiitis [11].…”

Section: Discussionmentioning

confidence: 99%

Renal Sarcoidosis Presenting as Acute Kidney Injury with Granulomatous Interstitial Nephritis

Bouchemla¹,

Chettati²,

Anselme³

et al. 2020

SJMCR

View full text Add to dashboard Cite

Sarcoidosis is a nonnecrotizing granulomatous disease of unknown origin that can affect lungs, eyes, kidneys and skin. Although kidney involvement is usually clinically silent, granulomatous interstitial nephritis -the hallmark of renal sarcoidosiscan lead to functional impairment and organ failure. We report a case of renal sarcoidosis revealed by acute kidney injury with biopsy finding of a granulomatous interstitial nephritis. Outcome was favorable after the institution of high dose corticosteroids.

show abstract

Acute kidney injury with granulomatous interstitial nephritis and vasculitis revealing sarcoidosis

Cited by 9 publications

References 0 publications

Vascular Involvement in Neurosarcoidosis

Vascular Involvement in Neurosarcoidosis

A Case Demonstrating the Pathological Relationship between Granulomatous Vasculitis and Glomerular Lesion in Renal Sarcoidosis

Renal Sarcoidosis Presenting as Acute Kidney Injury with Granulomatous Interstitial Nephritis

Contact Info

Product

Resources

About