Figure 810

Differential diagnosis of granulomatous lesions in renal sarcoidosis. Once considered rare, granulomatous interstitial nephritis is now observed in 10% of kidney biopsy results. Most of these are seen in cases of drug hypersensitivity. The commonly implicated drugs are antibiotics and nonsteroidal anti-inflammatory drugs. Sarcoidosis and Wegener's granulomatosis each account for 5% to 10% of cases observed on kidney biopsy. Other less common and rather rare causes include tuberculosis, angiitis, and lupus erythematosus. In some 15% to 20% of cases, the cause of the granulomatous lesions is never established.

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