February 1976

Sarcoid Granulomatous Nephritis Occurring as Isolated Renal Failure

Author Affiliations

From the Division of Renal Diseases, Rhode Island Hospital, Providence, and the Division of Biological and Medical Sciences, Brown University, Providence, RI.

Arch Intern Med. 1976;136(2):241-245. doi:10.1001/archinte.1976.03630020091021

Sarcoidosis is a systemic, granulomatous disease with protean clinical manifestations. Since a cause of this disease has not been determined, the diagnosis depends on the clinical picture and the pathological demonstration of noncaseating epithelioid granulomas. Leukopenia, hypergammaglobulinemia, delayed cellular immunity, and an increased erythrocyte sedimentation rate, although inconstantly present, help support the diagnosis when the clinical presentation is atypical or when the pathological lesion is difficult to demonstrate.1

Renal failure occurs rarely in sarcoidosis. When reported, it has been attributed most commonly to the consequences of increased sensitivity to vitamin D with subsequent disordered calcium metabolism.2 Less frequently, azotemia has resulted from granulomatous involvement of the kidney occurring in setting of overt, generalized sarcoidosis.3-6

We wish to report a patient who, in the absence of clinical manifestations of sarcoidosis elsewhere, developed renal failure caused by sarcoid granulomatous interstitial nephritis. The recognition that this disease may occur clinically

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