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Currently filtering by tag: Sarcoidosis

Diagnose This (October 19, 2020)

Sarcoidosis, kidney biopsy stain, arkana laboratories, renal pathology
What would be your leading diagnosis in a patient with elevated ACE levels and hilar lymphadenopathy?      ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​...

Granulomatous Interstitial Nephritis Differential

This biopsy is from a 25-year-old African American female with renal failure. The photomicrographs here show renal involvement by non-caseating granulomas eliciting the diagnosis of granulomatous interstitial nephritis. The patient was found to be hypercalcemic and to have hilar lymphadenopathy and reticulonodular infiltrates on chest x-ray and was diagnosed with sarcoidosis. A case series examining 46 cases of granulomatous interstitial nephritis (GIN) by Bijol et al (ref below) found the most common etiology (45%) of this pattern to be a drug-induced reaction. This was followed by sarcoidosis (29% of GIN), other (including infection) at 16% and there were 10% of...

Pushing Glass (September 20, 2017)

The patient is a 65-year-old African American female who presents with a protein/creatinine ratio of 2 and a serum creatinine of 3.5 mg/dl. Serologies for ANA, dsDNA, c-ANCA, p-ANCA, and rheumatoid factor are negative. On CT examination, she has several enlarged peribronchial lymph nodes. Her ACE level is elevated. What is the best diagnosis? A. Necrotizing Vasculitis. B. Acute Interstitial Nephritis Concerning for a Drug Reaction. C. Granulomatous Interstitial Nephritis Concerning for Sarcoidosis. D. ANCA-associated Vasculitis with Diffuse Crescents. The correct answer is c: Granulomatous Interstitial Nephritis Concerning for Sarcoidosis. The biopsy shows a florid example of non-caseating granulomas throughout...