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一例由结节病相关的肉芽肿性间质性肾炎引起的急性肾损伤病例。

A case of acute kidney injury caused by granulomatous interstitial nephritis associated with sarcoidosis.

作者信息

Horino Taro, Matsumoto Tatsuki, Inoue Kosuke, Ichii Osamu, Terada Yoshio

机构信息

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.

Department of Biomedical Sciences, Laboratory of Anatomy, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.

出版信息

CEN Case Rep. 2018 May;7(1):34-38. doi: 10.1007/s13730-017-0287-9. Epub 2017 Nov 27.

Abstract

Sarcoidosis affects multiple organs including lung, heart and kidney. Sarcoidosis causes hypercalcemia, hypergammaglobulinemia, and rarely, granulomatous interstitial nephritis, resulting in renal stromal damage. Granulomatous interstitial nephritis is characterized as interstitial nephritis with noncaseating epithelioid granulomas. Diagnosing granulomatous interstitial nephritis before patient's death is challenging; hence, only few cases proven by renal biopsy have been reported till date. We present a case of acute kidney injury caused by granulomatous interstitial nephritis as a renal manifestation of sarcoidosis proven by renal biopsy, which can be confirmed by F-fluorodeoxyglucose positron emission tomography/computed tomography. Glucocorticoid therapy was helpful for improving and maintaining her renal function over a 6-year period.

摘要

结节病可累及多个器官,包括肺、心脏和肾脏。结节病可导致高钙血症、高球蛋白血症,很少会引起肉芽肿性间质性肾炎,进而导致肾间质损伤。肉芽肿性间质性肾炎的特征为伴有非干酪样上皮样肉芽肿的间质性肾炎。在患者死亡前诊断肉芽肿性间质性肾炎具有挑战性;因此,迄今为止,经肾活检证实的病例报告很少。我们报告一例由肉芽肿性间质性肾炎引起的急性肾损伤,该病例为经肾活检证实的结节病肾脏表现,可通过F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描确诊。糖皮质激素治疗有助于在6年期间改善并维持她的肾功能。

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