Renal confined sarcoidosis: Natural history and diagnostic challenge

dc.contributor.authorGhafoor, Azam
dc.contributor.authorAlmakki, Akram
dc.contributor.departmentMedicine, School of Medicine
dc.date.accessioned2025-04-08T13:29:40Z
dc.date.available2025-04-08T13:29:40Z
dc.date.issued2014
dc.description.abstractA 69 year old male referred to nephrology clinic for uncontrolled hypertension. During his follow up over two years, he developed renal disease and hypercalcemia. He was found to have monoclonal gammopathy (MGUS). Urinalysis was negative except for Monoclonal IgG on immunoelectrophoresis. Workup for malignancy was negative including chest X-ray and bone marrow biopsy. He progressed into renal failure and ended up on dialysis. Interestingly, the renal biopsy showed non-caseating granulomas, and the patient was diagnosed with renal confined sarcoidosis which is extremely rare. PPD was negative. He was treated with Prednisone 60 mg daily. Surprisingly, his kidney disease was not responsive to steroids. Despite improvement in his calcium with treatment, his kidney function did not improve and he remained on hemodialysis but needed to stay on small dose of Prednisone to keep his calcium under control. Our case is the first in the literature that demonstrates the natural history of renal-confined sarcoidosis. In addition, the presence of MGUS created a diagnostic challenge and delayed diagnosis of sarcoidosis. Although the renal biopsy did not show direct damage from MGUS, a potential relation between renal sarcoidosis and MGUS is worth studied.
dc.eprint.versionFinal published version
dc.identifier.citationGhafoor A, Almakki A. Renal confined sarcoidosis: Natural history and diagnostic challenge. Avicenna J Med. 2014;4(2):44-47. doi:10.4103/2231-0770.130346
dc.identifier.urihttps://hdl.handle.net/1805/46888
dc.language.isoen_US
dc.publisherThieme
dc.relation.isversionof10.4103/2231-0770.130346
dc.relation.journalAvicenna Journal of Medicine
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.sourcePMC
dc.subjectHypercalcemia
dc.subjectMonoclonal gammopathy of undetermined significance
dc.subjectRenal-confined sarcoidosis
dc.titleRenal confined sarcoidosis: Natural history and diagnostic challenge
dc.typeArticle
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