Renal failure as primary manifestation of systemic sarcoidosis

Case Report: We report the history of a 67-year-old patient who was admitte d to hospital because of rapidly progressive renal insufficiency. The renal biopsy revealed granulomatous interstitial nephritis. The diagnosis of sys temic sarcoidosis was confirmed by typical findings of bronchoalveolar lava ge and of transbronchial, liver and bone marrow biopsy. Indications For sar coidosis-related nephrocalcinosis/nephrolithiasis or glomerulonephritis wer e absent. Simultaneously a monoclonal gammopathy of unknown significance (M GUS) was diagnosed. While the patient having been uremic at the time of dia gnosis, the administration of prednisolone effectively improved renal funct ion, Conclusions: As a rare manifestation of sarcoidosis granulomatous interstit ial nephritis can cause rapidly progressive renal insufficiency, which can effectively be treated by steroids, if distinct interstitial fibrosis is ab sent.