Steroids are the mainstay of treatment for renal
sarcoidosis. Many patients with
sarcoidosis are chronically dependent on
steroids and there is limited data on the use of
steroid-sparing agents. This is a case of a patient that has remained in remission using
mycophenolate mofetil (MMF) as a
steroid-sparing agent. The patient is a 56-year-old female with a history of
sarcoidosis diagnosed by lymph node biopsy who developed 3 episodes of
acute kidney injury (AKI) in the setting of exacerbations of her
sarcoidosis, each responding to
prednisone treatment. Due to possible lifelong need for
prednisone, MMF was started as a
steroid-sparing treatment. She tolerated the MMF well and has now been steroidfree for 22 months. There have been only a few case reports about the use of MMF as a
steroid-sparing agent in sarcoid-associated renal disease, in which patients could be successfully weaned off
steroids. This is the longest reported follow-up of a patient being off
steroids while on MMF. It is also notable for the patient having a relapse on the MMF which responded to an increased dose. MMF should be studied further as a potential
steroid-sparing agent in the treatment of sarcoid associated renal disease.