Harzallah Amel, Kaaroud Hayet, Boubaker Karima, Barbouch Samia, Goucha Rim, Hamida Fethi Ben, Abdallah Taieb Ben
Department of Medicine A, Charles Nicolle Hospital, Tunis, Tunisia.
Department of Laboratory of Renal Pathology LRSP001, Charles Nicolle Hospital, Tunis, Tunisia.
Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1157-1161. doi: 10.4103/1319-2442.215120.
Sarcoidosis is an inflammatory disease that affects mostly the lungs and lymph glands. Renal involvement is rare and especially vasculitis. We report a case who presented an acute kidney failure and had sarcoidosis with vasculitis and nodular splenic involvement. A 35-year-old woman presenting a Lofgren syndrome was hospitalized for acute renal failure with cervical lymphadenopathy without other clinical findings. Laboratory data disclosed elevated angiotensin converting enzyme serum level. Abdominal ultrasound showed a multinodular spleen. Renal histology revealed granulomatous interstitial nephritis with necrotizing vasculitis. Outcome was favorable after the institution of high dose corticosteroids along with cyclophosphamide. Renal involvement is rare in sarcoidosis. However, the diagnostic delay should be avoided to improve the outcome.
结节病是一种主要累及肺部和淋巴结的炎症性疾病。肾脏受累罕见,尤其是血管炎。我们报告一例出现急性肾衰竭、患有结节病合并血管炎及脾脏结节受累的病例。一名患有 Löfgren 综合征的 35 岁女性因急性肾衰竭伴颈部淋巴结肿大住院,无其他临床症状。实验室检查数据显示血清血管紧张素转换酶水平升高。腹部超声显示脾脏多发结节。肾脏组织学检查显示肉芽肿性间质性肾炎伴坏死性血管炎。在使用大剂量糖皮质激素联合环磷酰胺治疗后,病情转好。结节病中肾脏受累罕见。然而,应避免诊断延迟以改善预后。