Sarcoidosis with Normocalcemic Granulomatous Nephritis

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Abstract
5 cases of sarcoidosis with normocalcemic granulomatous nephritis and renal impairment are described. 24 earlier reported cases with normocalcemic granulomatous nephritis of sarcoidosis were extracted from the literature and reviewed together with the present cases. GFR was normal ( > 80 ml/min) in 2 of the patients, slightly to moderately decreased (80–20 ml/min) in 14 patients, and severely decreased ( < 20 ml/min) in 13 patients. The patients (19 males and 10 females) were 12–68 (median 45) years old. All patients with GFR less than 10 ml/min were more than 43 years old. 1 patient died in terminal uremia on admittance. All but 1 of the patients treated with corticosteroids improved (22 patients) or stabilized (5 patients) at least initially. 1 patient treated with a relatively low dose of a corticosteroid progressed to terminal uremia. 8 patients had a relapse when the corticosteroids were tapered or discontinued. 12 of the patients had residual renal impairment after initial successful treatment and in 4 cases the impairment worsened after a corticosteroid-sensitive relapse. It could be concluded from the study that an initial corticosteroid dosage of 1 mg prednisolone/kg B W or more should be used in granulomatous nephritis of sarcoidosis.

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