Renal failure and hypercalcemia as initial manifestations of extrapulmonary sarcoidosis

Carlos Ponce, Jaspal S Gujral

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Sarcoidosis is a granulomatous, multisystem disease. Rarely, sarcoidosis may present with both renal failure and hypercalcemia. A 27-year-old black man presented with severe abdominal pain and renal failure. A kidney biopsy demonstrated features of both interstitial nephritis and membranous glomerulopathy thought to be secondary to nonsteroidal anti-inflammatory drugs. His renal function and symptoms improved with short-term prednisone therapy. Discontinuation of steroids led to a recurrence of renal failure and severe hypercalcemia. On the basis of an elevated angiotensin-converting enzyme level of 160 U/L and anemia, a bone marrow biopsy was performed. Acid-fast bacillus-negative, noncaseating granulomas suggested the diagnosis of sarcoidosis. The patient recovered after restarting prednisone. Sarcoidosis may cause both interstitial and membranous nephritis from direct infiltration. Hypercalcemia results from increased calcium absorption secondary to 1,25-dihydroxyvitamin D production by sarcoid granulomas. Sarcoidosis must be considered in the differential diagnosis of renal failure in black patients. Serum calcium and angiotensin-converting enzyme levels may aid the diagnosis.

Original languageEnglish (US)
Pages (from-to)590-592
Number of pages3
JournalSouthern Medical Journal
Volume97
Issue number6
DOIs
StatePublished - Jun 1 2004

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Hypercalcemia
Sarcoidosis
Renal Insufficiency
Interstitial Nephritis
Peptidyl-Dipeptidase A
Prednisone
Granuloma
Calcium
Kidney
Biopsy
Membranous Glomerulonephritis
Bacillus
Abdominal Pain
Anemia
Differential Diagnosis
Anti-Inflammatory Agents
Bone Marrow
Steroids
Recurrence
Acids

Keywords

  • Hypercalcemia
  • Renal failure
  • Sarcoidosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Renal failure and hypercalcemia as initial manifestations of extrapulmonary sarcoidosis. / Ponce, Carlos; Gujral, Jaspal S.

In: Southern Medical Journal, Vol. 97, No. 6, 01.06.2004, p. 590-592.

Research output: Contribution to journalArticle

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