Renal sarcoidosis: five years follow up and treatment. Case report

Miguel Herrera, Internado Médico, Hospital Dr. Gustavo N. Collado, Herrera, Panamá
Norman E. Bustamante, Servicio de Nefrología, Hospital Dr. Gustavo N. Collado, Herrera, Panamá
Rolando Milord, Departamento de Patología, Universidad de Panamá, Ciudad de Panamá, Panamá
Karen Courville, Servicio de Nefrología, Hospital Dr. Gustavo N. Collado, Herrera;; Investigadora Asociada, Instituto de Ciencias Médicas, SNI; Panamá

Renal sarcoidosis is a rare, often overlooked entity, particularly when pulmonary manifestations are absent. We present the case of a 17-year-old female in Panama with stage 3b chronic kidney disease and persistent hypercalcemia. Renal biopsy confirmed non-caseating granulomatous interstitial nephritis. Following a recurrence of hypercalcemia during steroid tapering, mycophenolate mofetil was introduced as a steroid-sparing agent. Over a five-year follow-up, the patient achieved sustained calcium normalization and stable renal function. A high index of suspicion is required for patients with unexplained interstitial nephritis and hypercalcemia. Early recognition and individualized immunosuppressive strategies are vital to preventing disease progression and reducing treatment-related complications.

Keywords: Renal sarcoidosis. Hypercalcemia. Granulomatous interstitial nephritis. Mycophenolate mofetil. Chronic kidney disease.