Otani Megumi, Nagahama Kiyotaka, Nakamura Kento, Nagatomo Akiko, Yoshida Suzu, Okai Kazuhiro, Suzuki Ayaka, Sasaki Masato, Hirasawa Suguru, Aki Shota, Tanaka Hiroyuki
Department of Nephrology, Yokosuka Kyosai Hospital, 1-16 Yonegahamadori, Yokosuka, Kanagawa, 238-8558, Japan.
Department of Pathology, Kyorin University School of Medicine, Mitaka, Japan.
CEN Case Rep. 2025 Jun 16. doi: 10.1007/s13730-025-01008-y.
We report the first documented case of renal sarcoidosis developing after SARS-CoV-2 infection. The patient, a 59-year-old woman with no significant medical history, was diagnosed with COVID-19 after experiencing persistent fatigue and insomnia. Approximately three weeks after the infection, she developed a skin rash, prompting a biopsy that revealed epithelioid granulomas. A systemic evaluation using computed tomography identified enlarged bilateral hilar lymph nodes, and a needle aspiration biopsy confirmed the presence of epithelioid granulomas, leading to a diagnosis of sarcoidosis. Nine months after recovering from COVID-19, she was referred to the nephrology department due to progressive renal dysfunction. A renal biopsy demonstrated granulomatous interstitial nephritis with Schaumann bodies, consistent with renal sarcoidosis. Treatment with prednisolone (30 mg/day, 0.5 mg/kg/day) resulted in significant improvement in renal function, suggesting a potential link between SARS-CoV-2 infection and immune dysregulation. This case highlights the importance of monitoring renal function in patients with post-COVID-19 sarcoidosis, even in the absence of disease progression in other organs.
我们报告了首例有记录的新型冠状病毒感染后发生肾结节病的病例。该患者为一名59岁女性,无重大病史,在经历持续疲劳和失眠后被诊断为新冠肺炎。感染后约三周,她出现皮疹,活检显示为上皮样肉芽肿。计算机断层扫描进行的全身评估发现双侧肺门淋巴结肿大,针吸活检证实存在上皮样肉芽肿,从而诊断为结节病。从新冠肺炎康复九个月后,她因进行性肾功能不全被转诊至肾内科。肾活检显示为伴有舒曼小体的肉芽肿性间质性肾炎,符合肾结节病。泼尼松龙治疗(30毫克/天,0.5毫克/千克/天)使肾功能显著改善,提示新型冠状病毒感染与免疫失调之间可能存在联系。该病例强调了在新冠肺炎后结节病患者中监测肾功能的重要性,即使其他器官无疾病进展。