Infliximab as long-term maintenance in steroid-resistant and recurrent sarcoidosis in a renal transplant with central nervous system involvement

Sarcoidosis is a multisystemic, granulomatous disease of unknown aetiology, which commonly involves the lungs, skin and the eyes. Renal sarcoidosis is rare. Recurrent renal sarcoidosis leading to transplant graft failure in adults has not been reported. We report a single case of steroid-resistant sarcoid with recurrence in a renal transplant and the central nervous system that was managed with infliximab. We describe successful resolution of granulomas in the transplant kidney and stabilization of renal function with catastrophic central nervous system recurrence upon withdrawal of infliximab.