Sarcoïdose systémique et glomérulonéphrite extra-membraneuse

Aydi, Z.; Dhaou, B. Ben; Baïli, L.; Daoud, F.; Moussa, F. Ben; Boussema, F.; Rokbani, L.

doi:10.1016/j.pneumo.2014.07.004

Cited by 3 publications

(2 citation statements)

References 13 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Glomerular disease may appear before, simultaneously or after other manifestations of sarcoidosis. There may be a long latency period between the development of active sarcoidosis and glomerular involvement and inversely (128).…”

Section: Sarcoidosismentioning

confidence: 99%

Secondary Membranous Nephropathy. A Narrative Review

Moroni

Ponticelli²

2020

Front. Med.

View full text Add to dashboard Cite

Membranous nephropathy (MN) is a common cause of proteinuria and nephrotic syndrome all over the world. It can be subdivided into primary and secondary forms. Primary form is an autoimmune disease clinically characterized by nephrotic syndrome and slow progression. It accounts for ~70% cases of MN. In the remaining cases MN may be secondary to well-defined causes, including infections, drugs, cancer, or autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), urticarial vasculitis, sarcoidosis, thyroiditis, Sjogren syndrome, systemic sclerosis, or ankylosing spondylitis. The clinical presentation is similar in primary and secondary MN. However, the outcome may be different, being often related to that of the original disease in secondary MN. Also, the treatment may be different, being targeted to the etiologic cause in secondary MN. Thus, the differential diagnosis between primary and secondary MN is critical and should be based not only on history and clinical features of the patient but also on immunofluorescence and electron microscopy analysis of renal biopsy as well as on the research of circulating antibodies. The identification of the pathologic events underlying a secondary MN is of paramount importance, since the eradication of the etiologic factors may be followed by remission or definitive cure of MN. In this review we report the main diseases and drugs responsible of secondary MN, the outcome and the pathogenesis of renal disease in different settings and the possible treatments.

show abstract

Section: Sarcoidosismentioning

confidence: 99%

Secondary Membranous Nephropathy. A Narrative Review

Moroni

Ponticelli²

2020

Front. Med.

View full text Add to dashboard Cite

show abstract

“…The histopathological hallmark of renal sarcoidosis is granulomatous interstitial nephritis (GIN), which accounts for 30% to 78.7% of renal sarcoidosis [7][8][9]. Atypical histological findings such as glomerulonephritis [10], amyloidosis [11], and vasculitis [12] are occasionally reported, however, causality and mechanism have not been proven [13]. As a matter of fact, some atypical clinical features bring up concerns about possible confounding factors in the diagnosis of sarcoidosis with other granuloma-causing etiologies such as tuberculosis, fungal infection (Histoplasma, Candida, Rhodococcus) and druginduced interstitial nephritis (NSAIDs, PPI) [14,15].…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Sarcoidosis in a Young Male With Acute Renal Failure: A Case Report and Literature Review

De la Hoz,

Osman,

Ryad

et al. 2023

Cureus

View full text Add to dashboard Cite

Sarcoidosis presents in a variety of ways, but historically, renal involvement has been considered rare with an incidence of 0.7% and is seldom the presenting feature of the illness. Concomitant involvement of kidney and bone marrow is extremely rare. Atypical forms of presentation, such as in this case, may pose a true diagnostic challenge. A 20-year-old African-American male presented to the emergency department with vague symptoms including fatigue, malaise, anorexia, right-sided lower back pain, and nausea. Acute kidney injury was clearly evident, creatinine was 19.78 mg/dL (normal range 0.60-1.20 mg/dL), and BUN was 124.0 mg/dL (normal range 5.0-25.0 mg/dL). Laboratory results were also remarkable for leukopenia, microcytic anemia, hyperkalemia, anion gap metabolic acidosis, and non-PTH dependent hypercalcemia. Interestingly, urinalysis was equivocal and both chest x-ray (CXR) and abdominopelvic computed tomography (CT) scan were unrevealing. The patient was admitted to the hospital and required renal replacement therapy to stabilize his clinical condition while planning for a renal biopsy that was later performed. While awaiting pathological results, pancytopenia developed, and a bone marrow biopsy was then obtained. On further investigation, angiotensin-converting enzyme (ACE) turned out to be significantly elevated suggesting sarcoidosis. Renal biopsy showed moderate acute tubular injury, tubulitis, extensive interstitial edema, and infiltration by numerous non-caseating granulomas, which confirmed the diagnosis of sarcoidosis. Bone marrow histopathology revealed hypocellularity but no granulomatous infiltration. The patient remained largely asymptomatic throughout his hospital stay, with no signs or symptoms suggesting the involvement of other organs. High-dose corticosteroids were started and continued outpatient after discharge while still on hemodialysis. Pancytopenia resolved while on glucocorticoids and improvement in renal function was such that after roughly two months of steroids, renal replacement therapy was no longer necessary. Overall, kidney injury severe enough to require hemodialysis associated with pancytopenia in a previously healthy 20-year-old constitutes a rather rare sarcoidosis presentation. This highlights the importance of considering sarcoidosis as a possible cause of kidney and bone marrow dysfunction and emphasizes the need for timely biopsy to facilitate accurate diagnosis and early initiation of appropriate therapy to avoid delayed or inadequate care, especially considering that even severe damage is potentially reversible when identified early and treated promptly.

show abstract

Renal sarcoidosis

Bergner

Löffler

2018

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

If systematically screened for renal manifestations are likely to occur in up to 25-30% of all sarcoidosis patients. The most common histological form of renal sarcoidosis is the granulomatous interstitial nephritis; however, granulomas can be absent. Furthermore, one can find various forms of secondary glomerulonephritis. In cases with dysregulated calcium homeostasis, nephrocalcinosis and nephrolithiasis are commonly detectable kidney diseases. AA amyloidosis or renal masses because of granuloma formation are considered to be rare manifestations. In addition to glucocorticoids various immunosuppressive treatments such as tumor necrosis factor alpha inhibitors have proven to be effective based on case series.

show abstract

Sarcoïdose systémique et glomérulonéphrite extra-membraneuse

Cited by 3 publications

References 13 publications

Secondary Membranous Nephropathy. A Narrative Review

Secondary Membranous Nephropathy. A Narrative Review

A Rare Presentation of Sarcoidosis in a Young Male With Acute Renal Failure: A Case Report and Literature Review

Renal sarcoidosis

Contact Info

Product

Resources

About