Acute kidney injury as the presenting feature of sarcoidosis

Sudhir Mehta; Akashdeep Singh; Vikas Makkar

doi:10.21804/24-1-4459

Sudhir Mehta Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
Akashdeep Singh Department of Pulmonary Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
Vikas Makkar Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Abstract

Acute kidney injury is rarely the presenting feature of sarcoidosis. We report the case of a patient whose diagnosis was brought to light by the investigation of impaired kidney function. Concurrent hypercalcaemia was noted and prompted further investigation, which led to the diagnosis of sarcoidosis. This is a rare phenomenon and is an important consideration in the patient with acute kidney injury and hypercalcaemia, without an apparent explanation. Rapid improvement in both kidney function and hypercalcaemia occurred in response to treatment.

References

Rizzato G. Extrapulmonary presentation of sarcoidosis. Current opinion in pulmonary medicine. 2001; 7 (5): 295-7.

Mahfoudhi M, Mamlouk H, Turki S, Kheder A. Systemic sarcoidosis complicated ofacute renal failure: about 12 cases. The Pan African Medical Journal. 2015; 22: 75.

Mahevas M, Lescure FX, Boffa JJ, Delastour V, Belenfant X, Chapelon C, et al.Renal sarcoidosis: clinical, laboratory, and histologic presentation and outcome in 47 patients. Medicine. 2009; 88 (2): 98-106.

Casella FJ, Allon M. The kidney in sarcoidosis. Journal of the American Society of Nephrology : JASN. 1993; 3 (9): 1555-62.

Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. The New England journal of medicine. 2007; 357 (21): 2153-65.

Nunes H, Bouvry D, Soler P, Valeyre D. Sarcoidosis. Orphanet journal of rare diseases. 2007; 2: 46.

Hunninghake GW, Constable U, Ando M, et al. Statement on sarcoidosis. Am J Respir Crit Care Med 1999;160:736–55.

Jindal SK, Gupta D, Aggarwal AN. Sarcoidosis in India: practical issues and difficulties in diagnosis and management. Sarcoidosis Vasc Diffuse Lung Dis 2002;19:176–84.

MacSearraigh ET, Doyle CT, Twomey M, et al. Sarcoidosis with renalinvolvement. Postgrad Med J 1978;54:528–32.

Sharma R, Guleria R, Mohan A, et al. Clinical profile of 153 patients with biopsy proven sarcoidosis. Results from a centre in India [abstract]. J Assoc Physicians India 2003;51:1201.

Bambery P, Behera D, Gupta AK, et al. Sarcoidosis in north India: the clinical profile of 40 patients. Sarcoidosis 1987;4:155–8.

Adams JS, Singer FR, Gacad MA, Sharma OP, Hayes MJ, Vouros P, et al. Isolation and structural identification of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis. The Journal of clinical endocrinology and metabolism. 1985; 60 (5): 960-6.

Conron M, Young C, Beynon HL. Calcium metabolism in sarcoidosis and its clinical implications. Rheumatology (Oxford, England). 2000; 39 (7): 707-13.

Muther RS, McCarron DA, Bennett WM. Renal manifestations of sarcoidosis. Archives of internal medicine. 1981; 141 (5): 643-5.

Bergner R, Hoffmann M, Waldherr R, Uppenkamp M. Frequency of kidney disease in chronic sarcoidosis. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG. 2003; 20 (2): 126-32.