A case of renal sarcoidosis complicated by parotid gland and uterine lesions.

BACKGROUND: Sarcoidosis is a systemic disease that can affect multiple organs. While pulmonary sarcoidosis is most commonly observed, renal sarcoidosis occurs less frequently. We herein report a case of sarcoidosis with an exceptionally rare distribution including renal lesions. CASE PRESENTATION: A 51-year-old Japanese female was referred because of bilateral parotid swelling and renal dysfunction. Computed tomography scan showed the swelling of bilateral kidneys, parotid glands, and uterus. Ga scintigraphy also showed remarkable accumulation in these organs. Renal biopsy and cytological evaluations of parotid gland and uterus were performed and she was diagnosed as sarcoidosis of these organs. Treatment was initiated with prednisolone 40 mg/day and then renal dysfunction subsequently improved. In addition, the swelling of parotid glands and uterus improved and Ga accumulation in each organ had disappeared. CONCLUSION: This is a first case of renal sarcoidosis complicated by parotid glands and uterus lesions. Pathological findings and the reactivity observed in Ga scintigraphy indicated the presence of lesions in these organs.

The effects of zinc supplementation on body fat mass in hemodialysis patients: An open-label randomized controlled trial.

INTRODUCTION: Zinc deficiency is highly prevalent in HD patients. On the other hand, it remains unknown about the role of zinc in their nutritional status. METHODS: We conducted an open-label randomized controlled trial. We investigated (i) the relationship between serum zinc levels and body composition and (ii) the effects of zinc supplementation on the composition of 48 HD patients with zinc deficiency. RESULTS: Serum zinc levels were significantly correlated with body fat weight (p < 0.01), but not with nonfat tissue weight. Multiple regression analyses demonstrated that serum zinc levels were a significant independent predictor of body fat weight (p < 0.001). Furthermore, the weight of body fat significantly increased in the group that received 1-year zinc supplementation (p < 0.05), but not in the group that did not. CONCLUSION: Our findings indicate that zinc deficiency plays an important role in fat metabolism in HD patients with its deficiency.

Clinical Significance of Trace Element Zinc in Patients with Chronic Kidney Disease.

The trace element zinc is essential for diverse physiological processes in humans. Zinc deficiency can impair growth, skin reproduction, immune function, maintenance of taste, glucose metabolism, and neurological function. Patients with chronic kidney disease (CKD) are susceptible to zinc deficiency, which is associated with erythropoiesis-stimulating agent (ESA) hypo-responsive anemia, nutritional problems, and cardiovascular diseases as well as non-specific symptoms such as dermatitis, prolonged wound healing, taste disturbance, appetite loss, or cognitive decline. Thus, zinc supplementation may be useful for the treatment of its deficiency, although it often causes copper deficiency, which is characterized by several severe disorders including cytopenia and myelopathy. In this review article, we mainly discuss the significant roles of zinc and the association between zinc deficiency and the pathogenesis of complications in patients with CKD.