Sarcoidosis presenting as severe renin-dependent hypertension due to kidney vascular injury

Clin Kidney J. 2014 Aug;7(4):383-6. doi: 10.1093/ckj/sfu060. Epub 2014 Jun 23.

Abstract

Renal sarcoidosis embraces a wide variety of clinical patterns. Renal vascular involvement has seldom been reported and usually in the setting of systemic vasculitis. We report the case of a 22-year-old patient in whom inaugural manifestation of renal sarcoidosis consisted of severe hypertension associated with bilateral perfusion defects and tumour-like nodules. In the setting of renal sarcoidosis, our case suggests that renin-dependant hypertension may arise from renal ischaemia as a result of extrinsic compression of kidney blood vessels due to severe granulomatous inflammation.

Keywords: granulomatous vasculitis; hypertension; sarcoidosis; secondary hyperaldosteronism; tubulointerstitial nephritis.