Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis
Identifieur interne : 000B12 ( Main/Exploration ); précédent : 000B11; suivant : 000B13Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis
Auteurs : Varun Mamidi [Inde] ; Manikantan Shekar [Inde] ; Jaiju James Chakola [Inde] ; Vamsi Krishna Makkena [Inde] ; Jayakumar Matcha [Inde]Source :
- Case Reports in Nephrology [ 2090-6641 ] ; 2019.
Abstract
Sarcoidosis is a chronic disease characterized by noncaseating lesions involving any organ and tissue in the body. Hypercalcemia and acute kidney injury is a common renal presentation of sarcoidosis. Necrotizing sarcoid granulomatosis (NSG) is a granulomatous disease entity which presents with nodular masses of sarcoid like granuloma which primarily effects the lungs. It is a rare necrotizing variant of sarcoidosis. Extra pulmonary presentation of NSG is very rare.
We present a 36-year-old female with hypercalcemia and acute kidney injury refractory to treatment. Whole body Flourine-18-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) showed increased metabolic uptake with ill-defined lesions in the liver, spleen, and pelvic lymph nodes. Biopsy of the ill-defined lesions in the liver showed necrotizing granulomatous lesions without angiitis. All the markers of tuberculosis were negative and angiotensin converting enzyme levels were elevated. Patient improved with 1 mg/kg/day oral steroid therapy and is on regular follow-up with minimal dose of steroids.
Necrotizing sarcoid granulomatosis (NSG) is a rare systemic granulomatous disease. Due to its rarity and diagnostic difficulty, treatment is challenging for clinicians, pathologists and radiologists. Treatment of choice for symptomatic patients is steroid therapy. Prognosis is good with complete recovery.
Url:
DOI: 10.1155/2019/3736495
PubMed: 31781435
PubMed Central: 6875228
Affiliations:
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type="wicri:Area/Main/Exploration">000B12</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis</title><author><name sortKey="Mamidi, Varun" sort="Mamidi, Varun" uniqKey="Mamidi V" first="Varun" last="Mamidi">Varun Mamidi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author><author><name sortKey="Shekar, Manikantan" sort="Shekar, Manikantan" uniqKey="Shekar M" first="Manikantan" last="Shekar">Manikantan Shekar</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author><author><name sortKey="Chakola, Jaiju James" sort="Chakola, Jaiju James" uniqKey="Chakola J" first="Jaiju James" last="Chakola">Jaiju James Chakola</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author><author><name sortKey="Makkena, Vamsi Krishna" sort="Makkena, Vamsi Krishna" uniqKey="Makkena V" first="Vamsi Krishna" last="Makkena">Vamsi Krishna Makkena</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author><author><name sortKey="Matcha, Jayakumar" sort="Matcha, Jayakumar" uniqKey="Matcha J" first="Jayakumar" last="Matcha">Jayakumar Matcha</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author></analytic><series><title level="j">Case Reports in Nephrology</title><idno type="ISSN">2090-6641</idno><idno type="eISSN">2090-665X</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p> Sarcoidosis is a chronic disease characterized by noncaseating lesions involving any organ and tissue in the body. Hypercalcemia and acute kidney injury is a common renal presentation of sarcoidosis. Necrotizing sarcoid granulomatosis (NSG) is a granulomatous disease entity which presents with nodular masses of sarcoid like granuloma which primarily effects the lungs. It is a rare necrotizing variant of sarcoidosis. Extra pulmonary presentation of NSG is very rare. </p></sec><sec><title>Case presentation</title><p> We present a 36-year-old female with hypercalcemia and acute kidney injury refractory to treatment. Whole body Flourine-18-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) showed increased metabolic uptake with ill-defined lesions in the liver, spleen, and pelvic lymph nodes. Biopsy of the ill-defined lesions in the liver showed necrotizing granulomatous lesions without angiitis. All the markers of tuberculosis were negative and angiotensin converting enzyme levels were elevated. Patient improved with 1 mg/kg/day oral steroid therapy and is on regular follow-up with minimal dose of steroids. </p></sec><sec><title>Conclusion</title><p> Necrotizing sarcoid granulomatosis (NSG) is a rare systemic granulomatous disease. Due to its rarity and diagnostic difficulty, treatment is challenging for clinicians, pathologists and radiologists. Treatment of choice for symptomatic patients is steroid therapy. Prognosis is good with complete recovery.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Berliner, A R" uniqKey="Berliner A">A. R. Berliner</name></author><author><name sortKey="Haas, M" uniqKey="Haas M">M. Haas</name></author><author><name sortKey="Choi, M J" uniqKey="Choi M">M. J. Choi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Minisola, S" uniqKey="Minisola S">S. Minisola</name></author><author><name sortKey="Pepe, J" uniqKey="Pepe J">J. 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Otesile</name></author><author><name sortKey="Pawa, R" uniqKey="Pawa R">R. Pawa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Binesh, F" uniqKey="Binesh F">F. Binesh</name></author><author><name sortKey="Halvani, H" uniqKey="Halvani H">H. Halvani</name></author><author><name sortKey="Navabii, H" uniqKey="Navabii H">H. Navabii</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moyses Neto, M" uniqKey="Moyses Neto M">M. Moyses-Neto</name></author><author><name sortKey="Guimaraes, F M" uniqKey="Guimaraes F">F. M. Guimaraes</name></author><author><name sortKey="Ayoub, F H" uniqKey="Ayoub F">F. H. Ayoub</name></author><author><name sortKey="Vieira Neto, O M" uniqKey="Vieira Neto O">O. M. Vieira-Neto</name></author><author><name sortKey="Costa, J A C" uniqKey="Costa J">J. A. C. Costa</name></author><author><name sortKey="Dantas, M" uniqKey="Dantas M">M. 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Lee</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Mamidi, Varun" sort="Mamidi, Varun" uniqKey="Mamidi V" first="Varun" last="Mamidi">Varun Mamidi</name></noRegion><name sortKey="Chakola, Jaiju James" sort="Chakola, Jaiju James" uniqKey="Chakola J" first="Jaiju James" last="Chakola">Jaiju James Chakola</name><name sortKey="Makkena, Vamsi Krishna" sort="Makkena, Vamsi Krishna" uniqKey="Makkena V" first="Vamsi Krishna" last="Makkena">Vamsi Krishna Makkena</name><name sortKey="Matcha, Jayakumar" sort="Matcha, Jayakumar" uniqKey="Matcha J" first="Jayakumar" last="Matcha">Jayakumar Matcha</name><name sortKey="Shekar, Manikantan" sort="Shekar, Manikantan" uniqKey="Shekar M" first="Manikantan" last="Shekar">Manikantan Shekar</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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