Sarcoidosis with Granulomatous Interstitial Nephritis. Report of Three Cases.

Ikeda, Akihiko; Nagai, Sonoko; Kitaichi, Masanori; Hayashi, Michio; Hamada, Kunio; Shigematsu, Michio; Nagao, Taishi; Izumi, Tohru

doi:10.2169/internalmedicine.40.241

Cited by 18 publications

(12 citation statements)

References 10 publications

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“…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%

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%

Tubulointerstitial nephritis and uveitis

Pakzad-Vaezi

Pepple

2017

Current Opinion in Ophthalmology

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“…Elles sont dues soit à une néphrocalcinose, soit à une infiltration par des granulomes épithéloïdes et giganto-cellulaires [3,6,7]. Notre malade avait une protéinurie de 24 heures initialement à 4,6 g et une leucocyturie 100 elt/mm 3 .…”

Section: Discussionunclassified

“…Notre malade avait une protéinurie de 24 heures initialement à 4,6 g et une leucocyturie 100 elt/mm 3 . L'insuffisance rénale est la principale manifestation, parfois révélatrice de la néphropathie interstitielle sarcoïdosique [3][4][5]7,8] et elle est observée dans 10 à 20 % des cas au cours de la sarcoïdose [3,9] ce qui n'est pas le cas pour Z. Aydi et al…”

Section: Discussionunclassified

Sarcoïdose systémique et glomérulonéphrite extra-membraneuse

Aydi

Dhaou

Baïli

et al. 2014

Revue de Pneumologie Clinique

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“…Ikeda et al reported a case in which biopsy of a mass lesion of the left kidney showed GIN. Sarcoidosis was diagnosed because lung and skin biopsy showed granulomas and ACE was elevated [10]. Both cases had mild renal dysfunction and demonstrated reduction in the size of the mass lesion along with improvement of renal function by glucocorticoid therapy [9,10].…”

Section: Discussionmentioning

confidence: 99%

Long-term preserved renal function of a patient with mass-forming granulomatous interstitial nephritis by biopsy-based steroid therapy

et al. 2010

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In 2001, a 41-year-old Japanese woman was referred to our hospital because of severe renal dysfunction and fever of unknown origin. On admission, her serum creatinine was 8.7 mg/dL, urine protein was 0.3 g/day, and urine β(2)-microglobulin was 81,007 μg/day. Computed tomography (CT) scans showed bilateral contracted kidneys with a mass projecting from the lower pole of the right kidney. Biopsy of this lesion revealed interstitial nephritis and a noncaseating granuloma. Because extrarenal organ involvement or laboratory findings specific for sarcoidosis or other primary diseases were not detected, idiopathic granulomatous interstitial nephritis (GIN) was diagnosed. Prednisolone was started at dosage of 30 mg daily, and serum creatinine decreased to 5.5 mg/dL after 1 month. Her renal function was preserved for 8 years, but maintenance hemodialysis had to be started in 2009. A surgical specimen obtained after initiation of dialysis showed resolution of GIN in the renal mass lesion, which presumably resulted in preservation of renal function over the long term. Even in patients with severe renal dysfunction, histological diagnosis of GIN might lead to prognostic improvement because of appropriate therapeutic intervention.

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Sarcoidosis with Granulomatous Interstitial Nephritis. Report of Three Cases.

Cited by 18 publications

References 10 publications

Tubulointerstitial nephritis and uveitis

Tubulointerstitial nephritis and uveitis

Sarcoïdose systémique et glomérulonéphrite extra-membraneuse

Long-term preserved renal function of a patient with mass-forming granulomatous interstitial nephritis by biopsy-based steroid therapy

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