Singh Vishal, Dogra Pavitra Manu, Singh Pulkit, Ghosh Indranil, Singhal Gaurav
Senior Advisor (Medicine & Nephrology), Army Hospital (R&R), Delhi Cantt, India.
Medical Officer, MS Ramaiah Medical College, Bangalore, India.
Med J Armed Forces India. 2025 Jan-Feb;81(1):95-98. doi: 10.1016/j.mjafi.2023.06.003. Epub 2023 Jul 13.
Sarcoidosis is a multisystem granulomatous disease of unknown etiology, characterized by noncaseating epithelioid granuloma, multinucleate giant cells, and tissue destruction. While lung and lymph node involvement is common, isolated renal involvement is rare. We report the case of a 55-year-old female patient, with renal limited sarcoidosis, who presented with worsening sensorium and acute kidney injury. The investigation showed elevated levels of serum calcium and angiotensinogen converting enzyme; the imaging study of the chest was normal. The kidney biopsy performed for nonresolving acute kidney injury showed noncaseating granulomatous interstitial nephritis and the presence of concurrent Immunoglobulin A (IgA)nephropathy. She responded to a therapy comprising fluid resuscitation, hemodialysis, and oral steroids.
结节病是一种病因不明的多系统肉芽肿性疾病，其特征为非干酪样上皮样肉芽肿、多核巨细胞和组织破坏。虽然肺部和淋巴结受累较为常见，但孤立性肾脏受累则较为罕见。我们报告一例55岁女性患者，患有肾脏局限性结节病，表现为意识障碍加重和急性肾损伤。检查显示血清钙和血管紧张素原转换酶水平升高；胸部影像学检查正常。因急性肾损伤持续不缓解而进行的肾脏活检显示为非干酪样肉芽肿性间质性肾炎，并同时存在免疫球蛋白A（IgA）肾病。她对包括液体复苏、血液透析和口服类固醇在内的治疗有反应。
