Kidney non-tumor - Sarcoidosis

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Kidney non-tumor

Associated with systemic conditions

Sarcoidosis

Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 23 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Often white men lacking skin, eye or lung involvement
● Often hypercalcemia and fever at presentation of renal sarcoidosis (Medicine (Baltimore) 2009;88:98)
● Renal failure in <3% (Rev Pneumol Clin 2011;67:342)
● Cases with renal involvement difficult to diagnose on renal biopsy due to focal nature (Int J Nephrol Renovasc Dis 2011;4:131)

Case reports
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● 19 year old woman who died of rapidly progressive renal and respiratory failure (Arch Pathol Lab Med 1989;113:1295)
● With nephrotic syndrome resistant to steroids and immunosuppression (Arch Pathol Lab Med 1978;102:572)

Treatment
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● Prednisone for renal insufficiency (Arch Pathol Lab Med 1990;114:488)
● Renal transplantation, recurrence in 27% (Clin J Am Soc Nephrol 2010;5:2101)

Micro description
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● Diagnosis of exclusion
● Interstitial non-caseating granulomatous nephritis, nephrocalcinosis, often segmental thickening and wrinkling of glomerular capillary walls
● Granulomas look fibrotic with minimal or no lymphocytic cuffing (naked nuclei)

Micro images
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Various images

Granulomatous interstitial nephritis

Renal biopsy shows nonspecific features, which is common

Recurrence after renal transplant

Immunofluorescence
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● No specific findings

Electron microscopy description
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● Numerous single and coalescent calcific microspherules within basement membrane, paramesangial zone and mesangium

End of Kidney non-tumor > Associated with systemic conditions > Sarcoidosis

Ref Updated: 8/7/12

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