Doctors at St Petersburg University Clinic help patient with rare autoimmune disease to find out her diagnosis

The young woman had reached out to the University clinic after she had been unable to deal for those many months with a feeling of weakness, a loss of appetite, an elevated temperature, and pain in the joints. She had also been losing weight rapidly. Neither a general practitioner nor a rheumatologist had been able to determine the reason for her malaise. These doctors, however, had come up with one clue: their tests had revealed signs of severe renal dysfunction. With the results of these tests in hand, the patient appealed to the University clinic’s Department of Nephrology and Dialysis, and to nephrologist Ekaterina Parshina, who is head of the department.

The St Petersburg University Pirogov Clinic of High Medical Technologies

The University nephrologists decided to perform a renal biopsy, a morphological examination of the kidney tissue. As Ms Parshina pointed out, ‘A kidney biopsy is the "gold standard" for confirmation of kidney disease. It is a minimally invasive procedure that is carried out under local anaesthesia and ultrasonic control. For a nephrologist, it is invaluable. It often leads us not only to a diagnosis but also to a strategy for treatment and a personal prognosis for the patient.

In the long term, sarcoidosis causes tissue dystrophy and necrosis and leads to a loss of function of the organs involved.

Piecing together the history of the illness and the results of their tests, the nephrologists were able to diagnose sarcoidosis with damage to the kidneys and joints. The patient’s symptoms were not typical of this disease, which in more than 90 percent of all cases attacks the lungs and manifests itself as coughing, shortness of breath and discomfort in the chest. This time, however, it had affected the kidneys.

Nephrologist Ekaterina Parshina, Head of the Department of Nephrology and Dialysis at the St Petersburg University Pirogov Clinic of High Medical Technologies.

‘Since sarcoidosis of the kidneys is a rare form of the disease, there is no commonly accepted treatment,’ Ms Parshina explained. The University doctors chose drug therapy, which only a few days later had already significantly improved the patient’s condition. She felt much better, as her fever and the pain in her joints had subsided. Her kidney indicators, which had recently shown signs of deterioration, also began to gradually improve.

Six months after treatment, the function of the patient’s kidneys has stabilised at the level of stage two chronic kidney disease. ‘This is a very good outcome for what had been a serious condition,’ Ms Parshina noted. ‘When she appealed to the clinic’s specialists, this allowed our patient to not only significantly improve her health and the quality of her life but also to plan a pregnancy in the near future.’