Acute kidney injury due to renal sarcoidosis during etanercept therapy: a case report and literature review

Intern Med. 2015;54(9):1131-4. doi: 10.2169/internalmedicine.54.4188. Epub 2015 May 1.

Abstract

We herein report a case of renal sarcoidosis presenting as acute kidney injury (AKI) during treatment with etanercept for rheumatoid arthritis. Blood tests showed a high level of angiotensin-converting enzyme and a renal biopsy demonstrated non-caseating granulomatous tubulointerstitial nephritis. The administration of high-dose steroid therapy (1 mg/kg) and discontinuation of etanercept resulted in an improvement in the patient's renal function. Although renal sarcoidosis induced by anti-tumor necrosis factor (TNF) therapy is an extremely rare manifestation, this case suggests that renal sarcoidosis should be considered in the differential diagnosis of AKI in patients receiving anti-TNF therapy, as providing an early diagnosis and treatment is important for preventing irreversible renal impairment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Kidney Injury / diagnostic imaging
  • Acute Kidney Injury / etiology*
  • Aged, 80 and over
  • Antirheumatic Agents / administration & dosage
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / drug therapy*
  • Deferoxamine / analogs & derivatives
  • Diagnosis, Differential
  • Etanercept / administration & dosage
  • Etanercept / adverse effects*
  • Female
  • Gallium Radioisotopes
  • Humans
  • Octreotide / analogs & derivatives
  • Radionuclide Imaging / methods*
  • Sarcoidosis / chemically induced*
  • Sarcoidosis / complications
  • Sarcoidosis / diagnostic imaging
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / drug effects*

Substances

  • Antirheumatic Agents
  • Gallium Radioisotopes
  • Tumor Necrosis Factor-alpha
  • desferrioxamine B-succinyl-phenylalanine(1)-octreotide
  • Deferoxamine
  • Etanercept
  • Octreotide