Sarcoidosis presenting with hearing loss and granulomatous interstitial nephritis in an adolescent

Rheault, Michelle N.; Manivel, J. Carlos; Levine, Samuel C.; Sinaiko, Alan R.

doi:10.1007/s00467-006-0153-z

Cited by 14 publications

(6 citation statements)

References 27 publications

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“…While granulomas appear to be the exception in cases of TINU, they are the defining lesion in sarcoidosis. Sarcoidosis commonly affects the eye, and approximately 20% of patients with systemic sarcoidosis will develop granulomatous interstitial nephritis [25,26]. Thus when biopsies identify renal granulomas, and particularly if there is evidence of other systemic granulomatous disease, sarcoidosis rather than TINU is the preferred diagnosis.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…For example, another recent case report of a 22 year-old male with a bilateral, granulomatous, and hypertensive anterior uveitis, resulted in the diagnosis of TINU despite the presence of numerous non-caseating granulomas associated with interstitial nephritis on renal biopsy [28]. These cases highlight two important points: TINU is a diagnosis of exclusion, and that renal biopsy can help provide diagnostic clarity in challenging cases [26,29,30]. …”

Section: Differential Diagnosismentioning

confidence: 99%

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Tubulointerstitial nephritis and uveitis

Pakzad-Vaezi

Pepple

2017

Current Opinion in Ophthalmology

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Purpose of review Tubulointerstitial nephritis and uveitis (TINU) is an important yet under-recognized ocular inflammatory syndrome. This review summarizes key historical publications that identified and defined the syndrome, and more recent literature that reveal the importance of urinary beta-2 microglobulin testing and kidney biopsy in the diagnostic evaluation of patients with TINU. Additionally, research studies providing new insights into disease pathogenesis are highlighted. Recent findings In contrast with initial reports of TINU manifesting exclusively as an anterior uveitis in pediatric patients, more recent reports have identified TINU in patients of all ages with a wide range of ocular manifestations. Urinary beta-2 microglobulin has emerged as a sensitive and specific laboratory screening test, and the role of kidney biopsy in differentiating TINU from sarcoidosis continues to evolve. Genetic studies have identified HLA-DQA1*01, HLA-DQB1*05, and HLA-DRB1*01 as high risk alleles and the identification of anti-mCRP antibodies suggests a role for humoral immunity in disease pathogenesis. Management strategies have evolved to include systemic anti-inflammatory treatment as a result of important outcome studies in patients with significant renal and ocular disease. Summary With greater recognition, understanding, and treatment of this syndrome, both ocular inflammation and renal disease can be better addressed.

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Section: Differential Diagnosismentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

Tubulointerstitial nephritis and uveitis

Pakzad-Vaezi

Pepple

2017

Current Opinion in Ophthalmology

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“…After multiple debates, the question that nephrocalcinosis and/or GIN might have a better prognosis remains uncertain. In Table S1 , we have summarized all the studies of sarcoidosis with renal involvement in children that were the basis of this review [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

The Overlap of Kidney Failure in Extrapulmonary Sarcoidosis in Children—Case Report and Review of Literature

Mocanu

Bogos

Trandafir

et al. 2023

IJMS

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Sarcoidosis is a non-necrotizing granulomatous inflammatory multisystemic disorder of unknown etiology. In children, as in adults, it can involve a few or all organ systems to a varying extent and degree, entailing multisystemic manifestations. Kidney involvement in pediatric-onset adult-type sarcoidosis is rare, with a wide range of renal manifestations, most of them related to calcium metabolism. Children with renal sarcoidosis tend to be more symptomatic than adults, although male patients have a higher prevalence. We present the case of a 10-year-old boy who presented with advanced renal failure with nephrocalcinosis and important hepatosplenomegaly. The diagnosis was established by histopathological examination, with consequent cortisone therapy and hemodialysis. This review emphasizes that sarcoidosis should be considered in the differential diagnosis of pediatric patients with acute kidney insufficiency or chronic kidney disease of an unknown etiology. As far as we know, this is the first study regarding extrapulmonary sarcoidosis in children from Romania.

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“…5 While about 80% to 90% of cases of neurosarcoidosis involve the cranial nerves, the presentation of sudden hearing loss has been reported in about 30 pediatric cases in the reviewed literature. 6,7 This presentation can be very insidious; however, the clinician should have a low threshold for suspicion for an autoimmune disease so that appropriate immunosuppressive therapy can be initiated early in the course of disease. As in systemic disease, corticosteroid therapy can decrease the inflammation and thus reverse the hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A 15-Year-Old Boy With Facial Palsy and Progressive Hearing Loss

Huaynate-Cuadrado

Poulik

Ang

2016

Global Pediatric Health

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A 15-year-old previously healthy African American male developed peripheral facial palsy over the course of 10 days. His primary care physician prescribed steroids and acyclovir to which he initially showed improvement, which lasted for about a month. After the facial palsy was resolved, he started complaining of unilateral, intermittent headaches and progressive right-sided hearing loss that worsened over a month associated to dizziness. He was taken to the emergency department.

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Sarcoidosis presenting with hearing loss and granulomatous interstitial nephritis in an adolescent

Cited by 14 publications

References 27 publications

Tubulointerstitial nephritis and uveitis

Tubulointerstitial nephritis and uveitis

The Overlap of Kidney Failure in Extrapulmonary Sarcoidosis in Children—Case Report and Review of Literature

A 15-Year-Old Boy With Facial Palsy and Progressive Hearing Loss

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