Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis
Background. 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 present...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2019/3736495 |
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| author | Varun Mamidi Manikantan Shekar Jaiju James Chakola Vamsi Krishna Makkena Jayakumar Matcha |
| author_facet | Varun Mamidi Manikantan Shekar Jaiju James Chakola Vamsi Krishna Makkena Jayakumar Matcha |
| author_sort | Varun Mamidi |
| collection | DOAJ |
| description | Background. 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. Case presentation. 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. Conclusion. 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. |
| format | Article |
| id | doaj-art-1da6428c6b794651b295b23cb3ddb909 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-1da6428c6b794651b295b23cb3ddb9092025-02-03T01:21:33ZengWileyCase Reports in Nephrology2090-66412090-665X2019-01-01201910.1155/2019/37364953736495Acute Kidney Injury Secondary to Necrotizing Sarcoid GranulomatosisVarun Mamidi0Manikantan Shekar1Jaiju James Chakola2Vamsi Krishna Makkena3Jayakumar Matcha4Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IndiaDepartment of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IndiaDepartment of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IndiaDepartment of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IndiaDepartment of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IndiaBackground. 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. Case presentation. 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. Conclusion. 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.http://dx.doi.org/10.1155/2019/3736495 |
| spellingShingle | Varun Mamidi Manikantan Shekar Jaiju James Chakola Vamsi Krishna Makkena Jayakumar Matcha Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis Case Reports in Nephrology |
| title | Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis |
| title_full | Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis |
| title_fullStr | Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis |
| title_full_unstemmed | Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis |
| title_short | Acute Kidney Injury Secondary to Necrotizing Sarcoid Granulomatosis |
| title_sort | acute kidney injury secondary to necrotizing sarcoid granulomatosis |
| url | http://dx.doi.org/10.1155/2019/3736495 |
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