Trindade Filho JO, Amaro KDDS, Oliveira ADTD, Gomes CNAP, Costa HF, Trajano VN. The importance of histopathology in the diagnosis of isolated renal sarcoidosis: a case report.
ACTA ACUST UNITED AC 2018;
40:291-295. [PMID:
29944158 PMCID:
PMC6533950 DOI:
10.1590/2175-8239-jbn-2018-0069]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/23/2018] [Indexed: 12/18/2022]
Abstract
Introduction:
Sarcoidosis is a systemic inflammatory disease of unknown etiology,
characterized by the presence of non-caseating granulomas in several organs;
renal impairment alone is a rare condition. When it affects the kidneys, the
most prevalent manifestations are hypercalcemia and hypercalciuria. This
paper aims to address the topic of renal sarcoidosis, by means of a case
report, and reinstate the importance of histopathology in its diagnosis.
Methods:
The data came from an observational clinical study with a qualitative
approach, through an interview with the renal sarcoidosis patient and data
from her medical records.
Case report:
Patient D.M.S., 50 years old, Caucasian, presented with reddish eyes and body
pains lasting for fifteen days as first manifestations of the disease. Upon
kidney ultrasound scan, we found renal parenchymal nephropathy. Serial renal
function and metabolic tests reported anemia and progressive urea and
creatinine changes, as well as hypercalcemia and hypercalciuria, confirming
acute kidney failure (AKF). A histopathological examination suggested the
diagnosis, which was confirmed by clinical, laboratory and histopathological
data. There was therapeutic resolution after steroid therapy.
Discussion:
The symptomatology of sarcoidosis is diverse and often non-specific. Renal
manifestation, which usually occurs after organ involvement, is present in
less than 5% of patients, and about 1% to 2% of these patients may develop
AKF.
Conclusions:
The use of histopathology together with clinical and laboratory data to
diagnose isolated renal sarcoidosis, rule out other etiologies and introduce
early treatment is of paramount importance.
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