title: Acute kidney injury due to renal sarcoidosis during etanercept therapy: a case report and literature review.
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.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Akiyama
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Hironari
authors.initials: H
authors.lastname: Hanaoka
authors.forename: Masataka
authors.initials: M
authors.lastname: Kuwana
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
mesh_terms: D058186:Acute Kidney Injury / Q000000981:diagnostic imaging / Q000209:etiology*; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003676:Deferoxamine / Q000031:analogs & derivatives; D003937:Diagnosis, Differential; D000068800:Etanercept / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D015282:Octreotide / Q000031:analogs & derivatives; D011877:Radionuclide Imaging / Q000379:methods*; D012507:Sarcoidosis / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000187:drug effects*
chemical_list: D018501:Antirheumatic Agents; D005710:Gallium Radioisotopes; D014409:Tumor Necrosis Factor-alpha; C082116:desferrioxamine B-succinyl-phenylalanine(1)-octreotide; D003676:Deferoxamine; D000068800:Etanercept; D015282:Octreotide