گزارش یک مورد ساکوئیدوز با تظاهر آدنوپاتی زیر چانه ای و نارسایی کلیه

  A 68 years old women refer to our clinical of educational hospital    because of decrease appetite from 4 months ago , with constipation, polyuria and polydypsia, also she had 10 kg weigh loss during this time. In  examination: she had blood pressure of       mmHg, 3 small lymph nodes in submental region (1×1cm) also palpable  spleen. other examinations was totally normal. Befor admission she had evaluated for probable malignany by the resean of her syrptoms, The results y evaluation was: upper Gi-series ,    upper Gi endo scopy were normal .           Abdominal sonograply and CT scan with contrast agents show only mild splenomegaly. Creat= 2.9 mg/dl. BUN=40 mg/dl ca=12.5 mg/dl p=3/06 mg/dl Alp=185(100-240), CFR »35 cc/min . PTH was in normal limit. We evaluated the patient for probable solid tumors of breast and multiple myeloma. The results of evaluation were normal, thus we refer the patient for lymph node biopsy (submental lymphadenopathy). The result was non-    caseating granuloma consist of multinuclear Giant cells with asteroid body. Angiotension converting enzym level was high, the patients treated by prednisolon, the syptoms subsided and creatinin decrease to 1.5 mg/dl aft 4 months of treatment.