Renal granuloma as an extraintestinal manifestation in Crohn’s disease: A case report

Table 1 Summary of previously reported case studies of renal granulomatosis in Crohn’s disease

Ref.	Age (years)	Treatment	Renal impairment	Resolution of renal impairment	Follow up
Archimandritis and Weetch[5], 1993	22	Sulfasalazine, prednisolone	BUN 10 mmol to 19.9 mmol, CrCl reduced to 14-15 mL/minute2	Yes	Followed up in 4 years: Remission
Baumer et al[6], 1999	21		Elevated serum Cr 394 μmol/L	NA	Followed up in 4 years: ESRD
Unal et al[7], 2008	43	Prednisolone	Elevated serum Cr 256 μmol/L and CrCl 32.6 mL/minute2	Mild improvement	Followed up in 2 months and 4 months post diagnosis of granuloma on biopsy
Marcus et al[8], 2008	16	Steroids, infliximab	Elevated serum 221 μmol/L to 186 μmol/L, CrCl 35 mL/minute2	No	Followed up in 6 months: No improvement in renal function
Marcus et al[8], 2008	11	Prednisolone, 6MP, infliximab, 5-ASA	Elevated serum Cr 168 μmol/L at diagnosis	No	Follow up at time of writing: No improvement in renal function despite improving intestinal symptoms
Semjén et al[9], 2011	50	Nephrectomy	Elevated serum Cr	NA	Nil follows up
Polci et al[10], 2012	56	Steroid, anti-TNF	Serum Cr 97 μmol/L to 256 μmol/L, BUN 79 mg/dL, eGFR 24 mL/minute2	No	Follow-up in 1 year: Worsening renal function
Colvin et al[11], 2014	23	5-ASA ceased, prednisolone	Serum Cr 71-133 μmol/L to 203 μmol/L in 2 months	Mild improvement	Follow-up in 21 months: Improved renal function
Saha et al[12], 2014	17	Prednisone, azathioprine, infliximab	Serum Cr 398 μmol/L (reference 0.7-1.2 mg/dL), eGFR 18 mL/minute2	Mild improvement	26 months post renal biopsy: Referred for renal transplant
Timmermans et al[13], 2016	19	Prednisone, + tacrolimus	Elevated serum Cr 177 μmol/L, eGFR 43 mL/minute2	Mild improvement	Follow up renal function: Serum Cr 133 μmol/L, eGFR 60 mL/minute/1.73 m2
Timmermans et al[13], 2016	22	Prednisone, mycophenolate mofetil, ciclosporine	Serum Cr increased from 101 μmol/L to 160 μmol/L, eGFR 37 mL/minute2	No	Follow up: ESRD
Han et al[14], 2022	19	Prednisolone, infliximab	Elevated serum Cr 237 μmol/L	Yes	Follow up in 11 months: Improved Cr 2.12 μmol/L

6-MP: 6-mercaptopurine; 5-ASA: 5-aminosalicylic acid; TNF: Tumor necrosis factor; BUN: Blood urea nitrogen; CrCl: Creatinine clearance; Cr: Creatinine; eGFR: Estimated glomerular filtration rate; NA: Not available; ESRD: End-stage renal disease.