Epidemiological, Clinical and Follow-Up Data in a Series of Thirteen Renal Insufficiencies Complicating Sarcoidosis

Madiha Mahfoudhi^1,2*, Imen Gorsane^1,2, Amel Gaieb Battikh^1,2, Sami Turki^1,2, Hayet Kaaroud^1,2, Rym Goucha^1,2, Fathi Ben Hamida^1,2, Taïeb Ben Abdallah^1,2

¹Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia.
²Research Unit of Kidney Diseases (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia.

DOI: 10.4236/ojcd.2015.52009                

Abstract

The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It’s a retrospective study implicating 13 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and the interest of considering sarcoidosis diagnosis in case of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 13 women with an average age of 41 years. Biological investigations showed an abnormal normocalcemia in 8 cases, a hypercalcemia in 5 cases, a hypercalciuria in 11 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 540 umol/L. The renal echography was normal in all patients. The kidney biopsy performed in all patients showed tubulo-interstitial nephritis. The extra-renal signs were: pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymphadenopathy in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 3 cases and a polyarthritis in 6 cases. Six patients benefited from hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis should be made rapidly in order to avoid end stage renal failure.

Keywords

Sarcoidosis, Acute Renal Failure, Interstitial Nephritis, Granuloma

Conflicts of Interest

The authors declare no conflicts of interest.

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