Bergner Raoul, Hoffmann Martin, Waldherr Rüdiger, Uppenkamp Michael
Medizinische Klinik A, Klinikum der Stadt Ludwigshafen gGmbH, Heidelburg.
Sarcoidosis Vasc Diffuse Lung Dis. 2003 Jun;20(2):126-32.
Sarcoidosis is an immunemediated disease of unknown cause, characterized by noncaseating epithelioid granulomas, affecting multiple organs. Clinically apparent renal involvement is rare and has been documented mostly as case reports. The incidence of renal involvement ranges from 3-23% with a wide spectrum of abnormalities.
The aim of this study was to ivestigate the renal involvement in patients with sarcoidosis.
From 1995 to 2002 we diagnosed 46 patients with sarcoidosis. Fifteen patients suffered from acute sarcoidosis with arthritis, mediastinal adenopathy and erythema nodosum (Löfgren's-syndrome). Thirty-one patients had chronic sarcoidosis with organ involvement, such as granulomatous hepatitis, uveitis and pulmonary sarcoidosis. In 15 patients we found renal abnormalities, 10 patients underwent kidney biopsy. Six patients had nephrocalcinosis, 2 patients granulomatous interstitial nephritis, one patient interstitial nephritis without granuloma, and 1 patient suffered from IgA-glomerulonephritis. In 2 patients we found a combination of granulomatous interstitial nephritis either with nephrocalcinosis or with IgA-glomerulonephritis. In all patients the serum creatinine decreased after treatment with corticosteroids.
In our retrospective analysis we found renal abnormalities in about 48% of patients with chronic sarcoidosis, but never in patients with acute sarcoidosis (Löfgren's syndrome). We conclude that kidney involvement in chronic sarcoidosis is more frequent than previously reported.
结节病是一种病因不明的免疫介导性疾病，其特征为非干酪样上皮样肉芽肿，可累及多个器官。临床上明显的肾脏受累情况罕见，大多以病例报告形式记载。肾脏受累的发生率在3%至23%之间，存在广泛的异常表现。
本研究旨在调查结节病患者的肾脏受累情况。
1995年至2002年期间，我们诊断出46例结节病患者。15例患者患有急性结节病，伴有关节炎、纵隔淋巴结肿大和结节性红斑（ Löfgren综合征）。31例患者患有慢性结节病，伴有器官受累，如肉芽肿性肝炎、葡萄膜炎和肺部结节病。在15例患者中我们发现了肾脏异常，10例患者接受了肾活检。6例患者有肾钙质沉着症，2例患者有肉芽肿性间质性肾炎，1例患者有非肉芽肿性间质性肾炎，1例患者患有IgA肾小球肾炎。在2例患者中我们发现肉芽肿性间质性肾炎与肾钙质沉着症或IgA肾小球肾炎合并存在。所有患者在接受皮质类固醇治疗后血清肌酐均下降。
在我们的回顾性分析中，我们发现约48%的慢性结节病患者存在肾脏异常，但急性结节病（Löfgren综合征）患者中从未发现。我们得出结论，慢性结节病的肾脏受累情况比之前报道的更为常见。
