Granulomatous sarcoid nephropathy

Recurrent sarcoid granulomatous nephritis and reactive tuberculin skin test in a renal transplant recipient

End-stage renal failure developed in a patient with systemic sarcoidosis and granulomatous nephritis. She received a successful cadaveric renal transplant and was doing well for about six years before graft impairment occurred. At that time, her mother was found to have active open pulmonary tuberculosis, and she had a strongly reactive result on tuberculin skin testing. No clinical evidence of tuberculosis or systemic sarcoidosis was noted, but a renal graft biopsy specimen revealed the recurrence of an unusual sarcoid lesion identical to that which had occurred in her native kidney. Her condition responded to high-dose prednisone with improvement in graft function.

Multisystem sarcoid presenting with gingival hyperplasia

A case is reported in which granulomatous gingival hyperplasia was the presenting feature of generalised sarcoidosis. Treatment with oral prednisolone resulted in resolution of both the granulomatous lesion of the gums, and of proteinuria. It is pointed out that although on histological examination sarcoidosis in this site cannot be distinguished from Crohn's disease, the clinical appearance in this patient (and the only similar case in the literature) was quite different from that seen in oral Crohn's disease.