Rasch progrediente Niereninsuffizienz als Primärmanifestation einer systemischen Sarkoidose

Berner, B; Schulz, E.C.; Wieneke, Ursula; Reuß‐Borst, Monika; Sattler, B; Müller, Gerhard A.

doi:10.1007/bf03044760

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…GIN rarely shows clinical relevance and occurs mainly in patients with multi-organ disease [4]. It has only exceptionally been described as an initial [5], primary [6] or isolated manifestation of sarcoidosis [7][8][9][10][11][12][13][14][15][16]. Most cases, however, are usually seen with associated constitutional syndromes and some degree of systemic involvement.…”

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confidence: 99%

Granulomatous Interstitial Nephritis, Hypercalcemia and Rapidly Progressive Kidney Failure Secondary to Sarcoidosis with Exclusive Renal Involvement

et al. 2001

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confidence: 99%

Granulomatous Interstitial Nephritis, Hypercalcemia and Rapidly Progressive Kidney Failure Secondary to Sarcoidosis with Exclusive Renal Involvement

et al. 2001

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“…Patient 1 developed mild renal insufficiency with a good outcome. Renal insufficiency has also been associated to sarcoidosis [34]. The main complication of hepatic sarcoidosis is the development of portal hypertension with esophageal and fundic varices, but a case of hepatocellular carcinoma has been reported [35].…”

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confidence: 99%

Sarcoidosis in two patients with chronic hepatitis C treated with interferon, ribavirin and amantadine

Pérez-Álvarez

Pérez-López

Lombrana

et al. 2002

Journal of Viral Hepatitis

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We report two patients with chronic hepatitis C, both nonresponders to a previous course of interferon (IFN), who developed or suffered an exacerbation of sarcoidosis while under treatment with IFN-alpha2a, ribavirin and amantadine. Patient 1: symptoms appeared after week 4 and treatment was withdrawn at month 9 due to severe weight loss, marked dyspnea, muscular weakness, dryness of mouth and facial paralysis. Stage III pulmonary sarcoidosis and polyneuropathy were confirmed. The patient had become steroid dependent and nine months after cessation of the treatment dyspnea and muscular weakness still persisted. She achieved a complete sustained response of hepatitis C. Patient 2: presented with a previous diagnosis of granulomatous hepatitis with chronic active hepatitis C and chronic dermatitis. The treatment exacerbated a cutaneous sarcoidosis. Furthermore, hiliar adenopathies consistent with stage I sarcoidosis became evident. Sarcoidosis responded to corticosteroids, but elevated transaminases and hepatitis C viraemia resisted. Hence, the combination of amantadine with ribavirin and IFN can develop or exacerbate subclinical sarcoidosis. A synergistic effect of these three drugs is suggested.

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“…Embora existam relatos de rápida e progressiva queda da função renal em pacientes com sarcoidose, na maioria dos casos o diagnóstico é difícil, devido à presença concomitante de nefrocalcinose. [10][11][12][13] Em uma série relatada por Brause et al, a causa da insuficiência renal por sarcoidose em cinco de seis pacientes foi nefrite intersticial granulomatosa não caseosa. Dois desses pacientes, já sabidamente portadores da doença, apresentavam hipercalcemia antes do comprometimento renal.…”

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Insuficiência renal aguda secundária à sarcoidose

et al. 2009

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A sarcoidose é uma doença sistêmica de etiologia desconhecida, caracterizada pela inflamação crônica granulomatosa, que acomete com maior frequência os pulmões, a pele e os olhos e, muito raramente, detectamos envolvimento renal na patologia. Relatamos aqui o caso de uma paciente de 47 anos, branca, internada em uma unidade de emergência de Hospital Universitário, devido a sintomas e achados radiológicos sugestivos de pneumonia. Desde o início da internação ela se apresentava com quadro laboratorial de insuficiência renal aguda, inicialmente atribuída ao histórico recente de uso abusivo de anti-inflamatórios. No entanto, devido à evolução arrastada e aparentemente desfavorável, inclusive com necessidade de terapia renal substitutiva (TRS), a paciente foi submetida a uma biópsia renal para esclarecimento diagnóstico e avaliação prognóstica. A descrição histológica mostrava um quadro de nefrite intersticial aguda granulomatosa, característico de sarcoidose renal, diagnóstico confirmado após revisão do prontuário médico, que revelava internação anterior devido a evento pulmonar da doença. Iniciado tratamento com prednisona 1 mg/kg/dia, a paciente evoluiu com melhora do quadro de insuficiência renal aguda, não mais necessitando de TRS. Atualmente, a paciente é mantida em acompanhamento ambulatorial com função renal estável.Palavras-chave: sarcoidose, insuficiência renal aguda, nefrite intersticial aguda, hipercalcemia. AbstRActSarcoidosis is a systemic disease of unknown etiology, characterized by chronic granulomatous inflammation, which affects most frequently the lungs, skin, and eyes, and most rarely the kidneys. We report the case of a 47-year-old, white, woman admitted to the emergency unit of a university-affiliated hospital due to symptoms and radiologic findings suggestive of pneumonia. Since the beginning, her laboratory tests showed acute renal failure, initially attributed to the recent history of abuse of anti-inflammatory drugs. However, because of her protracted and apparently unfavorable evolution, requiring renal replacement therapy (RRT), she underwent renal biopsy for diagnosis and prognostic assessment. Histology showed acute granulomatous interstitial nephritis, characteristic of renal sarcoidosis, which was confirmed after review of the medical record disclosing a previous admission due to lung involvement of the disease. Treatment with prednisone (1mg/ kg/day) was initiated, acute renal failure improved, and the patient no longer required RRT. Currently she is followed up on an outpatient service, and her renal function is stable.

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Rasch progrediente Niereninsuffizienz als Primärmanifestation einer systemischen Sarkoidose

Abstract: As a rare manifestation of sarcoidosis granulomatous interstitial nephritis can cause rapidly progressive renal insufficiency, which can effectively be treated by steroids, if distinct interstitial fibrosis is absent.

Cited by 6 publications

References 25 publications

Granulomatous Interstitial Nephritis, Hypercalcemia and Rapidly Progressive Kidney Failure Secondary to Sarcoidosis with Exclusive Renal Involvement

Granulomatous Interstitial Nephritis, Hypercalcemia and Rapidly Progressive Kidney Failure Secondary to Sarcoidosis with Exclusive Renal Involvement

Sarcoidosis in two patients with chronic hepatitis C treated with interferon, ribavirin and amantadine

Insuficiência renal aguda secundária à sarcoidose

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