Figure 813

Obstructive nephropathy due to sarcoidosis. Acute deterioration of renal function in sarcoidosis very rarely results from obstructive nephropathy caused by intrarenal granulomatous infiltrates or from extensive retroperitoneal lymphadenopathy or fibrosis causing obstruction of the renal vasculature or ureteral outflow [3,4]. (From Grodin et al. [3]; with permission.)

Patient profile

A man aged 40 years with established diagnosis of pulmonary sarcoidosis that had responded to steroids Presentation: hypertension (200/140 mm Hg) and proteinuria (4 g/d) Intravenous pyelogram: asymmetric kidneys with delayed appearance of contrast on right Surgery: sclerotic matrix affecting aorta and proximal renal artery Kidney biopsy: focal and global glomerulosclerosis, interstitial fibrosis Postoperative course: persistent hypertension

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