Discrepant elevation of sIL-2R levels in sarcoidosis patients with renal insufficiency

Verwoerd, Anouk; Vorselaars, Adriane D.M.; Moorsel, Coline H.M. van; Bos, Willem Jan W.; Velzen‐Blad, Heleen van; Grutters, Jan C.

doi:10.1183/09031936.00005315

Cited by 13 publications

(6 citation statements)

References 13 publications

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“…Three patients had kidney dysfunction and associated high levels of sIL-2R, as previously described [41]. Their kidney function did not change during therapy.…”

Section: Inflammatory Biomarker and Organ Responsesupporting

confidence: 52%

Efficacy of adalimumab in sarcoidosis patients who developed intolerance to infliximab

Crommelin

Burg

Vorselaars

et al. 2016

Respiratory Medicine

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“…Three patients had kidney dysfunction and associated high levels of sIL-2R, as previously described [41]. Their kidney function did not change during therapy.…”

Section: Inflammatory Biomarker and Organ Responsesupporting

confidence: 52%

Efficacy of adalimumab in sarcoidosis patients who developed intolerance to infliximab

Crommelin

Burg

Vorselaars

et al. 2016

Respiratory Medicine

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“…Additionally, the clinical adaptation of this test may also come at a financial cost where sIL-2R level may not be readily available or is more expensive in some settings. Levels of sIL-2R can also be affected by factors such as renal function; hence, diagnostic interpretation of these results in a clinical setting should also be cautiously approached (7). Additional factors that would have affected the levels include the variations in the laboratory methods used to assess the sIL-2R levels.…”

Section: Discussionmentioning

confidence: 99%

Role of Serum Soluble Interleukin-2 Receptor Level in the Diagnosis of Sarcoidosis: A Systematic Review and Meta-Analysis

Gupta

Parmar

Padappayil

et al. 2022

Preprint

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IntroductionSerum Soluble Interleukin-2 Receptor (sIL-2R) levels are used clinically as a disease activity marker for systemic sarcoidosis. Studies have investigated the diagnostic role of serum soluble interleukin-2 receptor (sIL-2R) level for sarcoidosis relative to biopsy. We performed a systematic review and meta-analysis of studies evaluating the diagnostic utility of sIL-2R.MethodsWe carried out an electronic search in Medline, Embase, Google Scholar, and Cochrane databases using keyword and Medical Subject Heading (MeSH) terms: sarcoidosis and sIL-2R. Studies evaluating the sIL-2R levels as a diagnostic tool in clinically diagnosed or biopsy-proven sarcoidosis patients compared to control groups with non-sarcoidosis patients were included. Forest plots were constructed using a random effect model depicting pooled sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy.ResultsWe selected ten studies comprising 1477 patients, with 592 in the sarcoidosis group and 885 in the non-sarcoidosis group. Pooled sensitivity and specificity of sIL-2R levels were 0.88 (95% CI: 0.75-0.95) and 0.87 (95% CI 0.73-0.94) respectively. Pooled negative predictive value and positive predictive value were 0.91 (95% CI 0.77-0.97) and 0.85 (95% CI 0.59-0.96) respectively with diagnostic accuracy of 0.86 (95% CI 0.71-0.93).ConclusionIn addition to its utility as a marker of sarcoidosis disease activity, sIL-2R has high diagnostic accuracy. Despite the limitations of the heterogenous sarcoidosis population and different sIL-2R cutoffs, our results suggest that sIL-2R is an important biomarker that can be used to confirm sarcoidosis diagnosis in unconfirmed or unclear cases.

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“…However, in renal function impairment sIL2R may increase due to impaired clearance which may lead to an overestimation of disease activity. 22 Data on the course of sIL2R levels in renal sarcoidosis are currently not available and the role of sIL2R as a biomarker in renal sarcoidosis and renal function impairment therefore remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

Renal involvement in sarcoidosis: Histologic findings and clinical course

Naderi

Amann

Janssen

2019

Nephrology @ Point of Care

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Background: Renal failure in sarcoidosis is rare and data on its long-term outcome are scarce. Aim: To investigate the pattern of renal involvement in sarcoidosis, its clinical course and response to treatment in the long-term. Methods: A single-center retrospective study with review of renal biopsies and medical charts was performed. Results: Between January 2005 and December 2016, seven patients with sarcoidosis underwent a kidney biopsy. This is equivalent to a frequency of 1.6% in a total of 434 biopsies from native kidney performed in our institution. All patients presented with renal failure. Five patients had granulomatous interstitial nephritis (GIN) and one patient each interstitial nephritis without granuloma and nephrocalcinosis. Three patients had concomitant glomerular disease: IgA nephropathy (n = 2), membranous and focal proliferative glomerulonephritis (n = 1). Most patients (n = 5) presented with hypercalcemia. All patients initially received oral prednisolone 1 mg/kg/day (n = 3) or 0.5 mg/kg/day (n = 4), respectively, with subsequent tapering or suspension. One patient was started on azathioprine after 18 months to spare steroids. After a mean follow-up of 59 months mean estimated glomerular filtration rate (eGFR) had improved from 19 ± 7 at presentation to 49 ± 16 mL/min. No patient required dialysis. All patients started on prednisolone 1 mg/kg/day developed transient diabetes mellitus while patients on 0.5 mg/kg/day did not. Renal function improvement did not differ between both treatment groups. Conclusion: GIN was the most common diagnosis in sarcoidosis patients with renal failure. Initial hypercalcemia was observed in the majority. Early steroid treatment lead to sustained renal function improvement.

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Discrepant elevation of sIL-2R levels in sarcoidosis patients with renal insufficiency

Cited by 13 publications

References 13 publications

Efficacy of adalimumab in sarcoidosis patients who developed intolerance to infliximab

Efficacy of adalimumab in sarcoidosis patients who developed intolerance to infliximab

Role of Serum Soluble Interleukin-2 Receptor Level in the Diagnosis of Sarcoidosis: A Systematic Review and Meta-Analysis

Renal involvement in sarcoidosis: Histologic findings and clinical course

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