Acute interstitial nephritis secondary to sarcoid-like reaction after autologous bone marrow transplantation: Case report

Author:

Lutf Luciana G1ORCID,Strufaldi Fernando L1,Cavalcante Livia B2ORCID,Caires Renato A1,Kawassaki Alexandre M3,Mattedi Francisco Z1,Costalonga Elerson C1ORCID,Soares Iberê C4,Szor Roberta Shcolnik5,Costa e Silva Verônica T1

Affiliation:

1. Cancer Institute of the State of Sao Paulo, Nephrology Division, Faculty of Medicine of University of São Paulo (FMUSP), Sao Paulo, SP, Brazil

2. CICAP Pathology Laboratory, Sao Paulo, SP, Brazil

3. Cancer Institute of the State of Sao Paulo Pumonology Division, Faculty of Medicine of University of São Paulo (FMUSP), Sao Paulo, SP, Brazil

4. Cancer Institute of the State of Sao Paulo Pathology Laboratory – Discipline of Pathology, Faculty of Medicine of University of São Paulo (FMUSP), Sao Paulo, SP, Brazil

5. DASA Group Hematology, Hospital 9 de Julho, Sao Paulo, SP, Brazil

Abstract

Sarcoid-Like Reaction is a systemic inflammatory granulomatous condition that does not meet the criteria for systemic Sarcoidosis—it is triggered by a known underlying factor, such as immunosuppression. Here we report a case of acute interstitial nephritis without granuloma in the context of a Sarcoid-Like systemic disease in the three-year period after an autologous stem cell transplant. The patient presented with a suspected relapse, associated with hemolytic anemia and an increase of serum creatinine. The investigation showed non-caseating epithelioid cell granuloma in a chest lymph node and in bone marrow, associated with combined hypogammaglobulinemia. Evaluation of the kidney tissue demonstrated acute interstitial nephritis.

Publisher

SAGE Publications

Subject

General Medicine

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