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一名儿科患者出现结节病伴肾炎和胰腺炎:罕见病例

Sarcoidosis Presenting With Nephritis and Pancreatitis in a Pediatric Patient: A Rare Case.

作者信息

Nazer Njood, Al Zahrani Reem A, Alotaibi Najla, Basahl Emtenan, Nashawi Mohammed

机构信息

Pediatrics, King Fahad Military Medical Complex, Jeddah, SAU.

Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.

出版信息

Cureus. 2024 Oct 1;16(10):e70635. doi: 10.7759/cureus.70635. eCollection 2024 Oct.

Abstract

Sarcoidosis is a multisystem granulomatous disorder of undetermined etiology that usually affects the lungs. It is a rare presentation to have an association between sarcoidosis and pancreatitis. We present a challenging case of acute pancreatitis and kidney dysfunction which had been diagnosed later to be sarcoidosis. A 12-year-old boy with abdominal pain and weight loss for one month, however, had no respiratory manifestations. Investigations revealed elevated lipase and creatinine. The patient was managed for acute kidney injury with an initial suspicion for autoimmune pancreatitis. Further workup revealed acute interstitial nephritis with non-necrotizing granuloma on renal biopsy. He developed uveitis and was found to have a variant in the angiotensin-converting enzyme (ACE) gene, which led to the diagnosis of sarcoidosis. According to our knowledge, this is the first case with juvenile sarcoidosis involving the pancreas and kidney.

摘要

结节病是一种病因不明的多系统肉芽肿性疾病,通常累及肺部。结节病与胰腺炎相关的情况较为罕见。我们报告一例具有挑战性的急性胰腺炎和肾功能不全病例,后来诊断为结节病。一名12岁男孩腹痛、体重减轻1个月,但无呼吸道症状。检查发现脂肪酶和肌酐升高。患者最初因怀疑自身免疫性胰腺炎而按急性肾损伤进行治疗。进一步检查发现肾活检显示急性间质性肾炎伴非坏死性肉芽肿。他出现了葡萄膜炎,并且发现血管紧张素转换酶(ACE)基因有变异,从而诊断为结节病。据我们所知,这是首例涉及胰腺和肾脏的青少年结节病病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ec4/11526808/6dd2778ddf53/cureus-0016-00000070635-i01.jpg

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