A Case of Sarcoidosis Associated with Renal Failure in a Kidney Transplant Patient

Abstract

본 증례는 당뇨병성 신증으로 인한 신부전으로 신이식 후 발생한 신장 유육종증의 예로, 육아종성 간질성 신염에 의해 신기능 악화 소견을 보였으나 스테로이드에 치료 반응을 보였으며, 신이식 후 신기능 저하의 감별진단에 드물지만 신장 유육종증도 포함되어야 하겠다.

Sarcoidosis, systemic inflammatory disease characterized by non-caseating granulomas, is rarely associated with renal failure in a kidney transplant. We report a 51-year-old woman with a kidney transplant who was diagnosed to have renal sarcoidosis. After 7 years of renal transplantation, the patient presented with relatively rapid deterioration of renal function and, subsequently, she underwent kidney transplant biopsy. Renal biopsy revealed interstitial nephritis with non-caseating granulomas compatible with granulomatous interstitial nephritis (GIN). She was also found to have granulomatous lymphadenitis and skin lesions. Diagnosis of sarcoidosis was made based on histopathologic findings, the high serum angiotensin converting enzyme level and exclusions of other causes of GIN including tuberculosis, ANCA associated glomerulonephritis and tubulointerstitial nephritis and uveitis syndrome. The patient was started on oral prednisolone, and subsequently her renal function improved.