title: Renal sarcoidosis with limited lung manifestations expressing Propionibacterium acnes antigens in the affected tubulointerstitium.
abstract: Sarcoidosis is a granulomatous multisystemic disorder of unknown origin that can affect the kidneys. Previous reports from Japan and Europe have indicated a link between Propionibacterium acnes infections and sarcoidosis. Here, we present the case of a 68-year-old woman with hypercalcemia and renal failure. A kidney biopsy was performed, which showed granulomatous tubulointerstitial nephritis with a large nonnecrotic nodule that contained mononuclear inflammatory cells and multinucleated giant cells. Subsequent immunohistochemical analysis revealed intracytoplasmic structures, which strongly indicated the presence of the P acnes antigen. Treatment with methylprednisolone ameliorated the patient's hypercalcemia and renal failure. This case report emphasizes the potential of chronic P acnes infection to cause sarcoidosis.
authors.affiliation: Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Fumie
authors.initials: F
authors.lastname: Satoh
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morita
authors.forename: Hironori
authors.initials: H
authors.lastname: Tayama
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Eishi
authors.forename: Ashio
authors.initials: A
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000276:immunology*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D016516:CD4-CD8 Ratio; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D011425:Propionibacterium acnes / Q000276:immunology*; D012507:Sarcoidosis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D000942:Antigens, Bacterial; D011239:Prednisolone