신이식 환자에서 신부전을 동반한 신장 유육종증 1예
A Case of Sarcoidosis Associated with Renal Failure in a Kidney Transplant Patient
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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.
Abstract
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.
참고문헌 (9)
- "Statement on sarcoidosis: joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee", Am J Respir Crit Care Med, 160, pp.736~755 (1999)
- Reich JM, "Mortality of intrathoracic sarcoidosis in referral vs population-based settings: influence of stage, ethnicity, and corticosteroid therapy", Chest, 121, pp.32~39 (2002)
- Javaud N, "Renal granulomatoses : a retrospective study of 40 cases and review of the literature", Medicine (Baltimore), 86, pp.170~180 (2007)
- Chang DK, "A case of sarcoidosis with hypopituitarism, diabetes inspidus and renal insufficiency", Korean J Med, 48, pp.682~689 (1995)
- Park JH, "A case of renal sarcoidosis presented with hypercalcemia and acute renal failure", Korean J Nephrol, 19, pp.368~371 (2000)
- Min BY, "A case of sarcoidosis presenting with multiple papules, hypercalcemia, and renal failure", Korean J Med, 77, pp.1226~1230 (2009)
- Vargas F, "Recurrence of granulomatous interstitial nephritis in transplanted kidney", Pediatr Transplant, 14, pp.54~57 (2010)
- Joss N, "Granulomatous interstitial nephritis", Clin J Am Soc Nephrol, 2, pp.222~230 (2007)
- Mahévas M, "Renal sarcoidosis: clinical, laboratory, and histologic presentation and outcome in 47 patients", Medicine (Baltimore), 88, pp.98~106 (2009)