Sarcoidosis presenting as multiple pulmonary nodules and nephrotic syndrome

Abstract

Summary:A 56 year old man presented with thrombophlebitis, nephrotic range proteinuria and multiple pulmonary nodules. A renal biopsy showed membranous glomerulonephritis, and after a thoracotomy a diagnosis of sarcoidosis was established.A pulmonary nodular pattern is unusual in sarcoidosis and is often mistaken for malignant disease. The association of this type of pulmonary involvement and membranous glomerulonephritis as the presenting form of sarcoidosis has not previously been described.

Sarcoidosis with Membranous Nephropathy and Granulomatous Interstitial Nephritis.

“…Enhanced production of immunoglobulins may be involved in the pathogenesis of membranousglomerulonephritis, but neither antigen nor specific antibody have been identified in the glomerular immunedeposits. As many as 70%of patients with sarcoidosis have circulating immune complexes (CICs), but in two cases with glomerular involvement where CICs were sought, they were not found (3,7). In the present case, CICs were not measured.…”