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Infliximab as long-term maintenance in steroid-resistant and recurrent sarcoidosis in a renal transplant with central nervous system involvement.

Srivastava S, Rajakariar R, Ashman N, Raftery M, Brown H, Martin JE - Clin Kidney J (2012)

Bottom Line: Sarcoidosis is a multisystemic, granulomatous disease of unknown aetiology, which commonly involves the lungs, skin and the eyes.Renal sarcoidosis is rare.We describe successful resolution of granulomas in the transplant kidney and stabilization of renal function with catastrophic central nervous system recurrence upon withdrawal of infliximab.

View Article: PubMed Central - PubMed

Affiliation: Renal Unit,The Royal London Hospital, London.

ABSTRACT
Sarcoidosis is a multisystemic, granulomatous disease of unknown aetiology, which commonly involves the lungs, skin and the eyes. Renal sarcoidosis is rare. Recurrent renal sarcoidosis leading to transplant graft failure in adults has not been reported. We report a single case of steroid-resistant sarcoid with recurrence in a renal transplant and the central nervous system that was managed with infliximab. We describe successful resolution of granulomas in the transplant kidney and stabilization of renal function with catastrophic central nervous system recurrence upon withdrawal of infliximab.

No MeSH data available.


Related in: MedlinePlus

Scarring presumed secondary to previous granulomatous tubulointerstitial nephritis, but no active inflammation on biopsy.
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fig3: Scarring presumed secondary to previous granulomatous tubulointerstitial nephritis, but no active inflammation on biopsy.

Mentions: We treated this patient with infliximab 5 mg/kg at 0, 2 and 6 weeks as induction and 8 weekly maintenance infusions. His cyclosporine was withdrawn with MMF and prednisolone (25 mg) ongoing. At Month 4 re-assessment, his prednisolone was at 15 mg with serum creatinine, 110 mmol/L. He had had four infliximab infusions completed without any adverse events. A repeat renal biopsy was performed (Figure 3). This showed marked reduction in the granulomatous TIN.


Infliximab as long-term maintenance in steroid-resistant and recurrent sarcoidosis in a renal transplant with central nervous system involvement.

Srivastava S, Rajakariar R, Ashman N, Raftery M, Brown H, Martin JE - Clin Kidney J (2012)

Scarring presumed secondary to previous granulomatous tubulointerstitial nephritis, but no active inflammation on biopsy.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400454&req=5

fig3: Scarring presumed secondary to previous granulomatous tubulointerstitial nephritis, but no active inflammation on biopsy.
Mentions: We treated this patient with infliximab 5 mg/kg at 0, 2 and 6 weeks as induction and 8 weekly maintenance infusions. His cyclosporine was withdrawn with MMF and prednisolone (25 mg) ongoing. At Month 4 re-assessment, his prednisolone was at 15 mg with serum creatinine, 110 mmol/L. He had had four infliximab infusions completed without any adverse events. A repeat renal biopsy was performed (Figure 3). This showed marked reduction in the granulomatous TIN.

Bottom Line: Sarcoidosis is a multisystemic, granulomatous disease of unknown aetiology, which commonly involves the lungs, skin and the eyes.Renal sarcoidosis is rare.We describe successful resolution of granulomas in the transplant kidney and stabilization of renal function with catastrophic central nervous system recurrence upon withdrawal of infliximab.

View Article: PubMed Central - PubMed

Affiliation: Renal Unit,The Royal London Hospital, London.

ABSTRACT
Sarcoidosis is a multisystemic, granulomatous disease of unknown aetiology, which commonly involves the lungs, skin and the eyes. Renal sarcoidosis is rare. Recurrent renal sarcoidosis leading to transplant graft failure in adults has not been reported. We report a single case of steroid-resistant sarcoid with recurrence in a renal transplant and the central nervous system that was managed with infliximab. We describe successful resolution of granulomas in the transplant kidney and stabilization of renal function with catastrophic central nervous system recurrence upon withdrawal of infliximab.

No MeSH data available.


Related in: MedlinePlus