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| 증례 : 고칼슘혈증과 급성신부전으로 발현한 Renal Sarcoidosis 1예 (A Case of Renal Sarcoidosis Presented with Hypercalcemia and Acute Renal Failure) |
| 박정식(Jung Sik Park),이상구(Sang Koo Lee),김순배(Soon Bae Kim),박종하(Jong Ha Park),정재걸(Jae Gul Chung),이우제(Woo Je Lee) |
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| Abstract |
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We report a case of renal sarcoidosis accompanied by hypercalcemia and renal insufficiency. A 52-year-old woman presented to hospital with nausea, pruri-tus, general weakness and weight loss. Laboratory tests revealed a serum creatinine was 3.6mg/dL, cal-cium ll.lmg/dL(ionized calcium 5.6mg/dL), hemoglobin 10.2g/dL, parathyroid hormone <3.0pg/mL, 24 hour urinary protein 1,127mg/day and 24 hour urinary calcium 489mg/day. Chest X-ray showed normal and both kidneys were within normal size with mild increased echo- genicity on renal ultrasound. Renal biopsy showed interstitial nephritis with mononuclear cell infiltration and mild interstitial fibrosis. Non-caseating granuloma with epitheloid and giant cells were seen. Following corticosteroid therapy, renal function and hypercalcemia were dramatically improved. Within 1 month, calcium level was normal and the creatinine level fell to 2.0mg/dL and subsequently remained stable while corticosteroid was progressively tapered off. She has been followed up for 11 months with normal seum calcium level and the creatinine level of 1.9mg/dL. |
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