Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
144 Doctors are Online

If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys?

User rating for this question
Very Good
Answered by

Radiologist
Practicing since : 2005
Answered : 34 Questions
Question
hi,
in sarcoidosis usually lungs are involved but in some patients kidneys are involved too.
if a patient has mild to moderate pulmonary sarcoidosis but no renal involvement and renal functions are normal can ct venogram with iv contrast activate or triger sarcoidosis in kidneys too?
Posted Sun, 2 Sep 2012 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Ranjeet Jagdale 3 hours later
Hello,

Thanks for posting your query.

There is no such report in literature, which has documented renal involvement, post contrast injection. Also, not so in patients with pulmonary sarcoidosis.

However, you should take general precautions recommended for contrast media use and most important is having adequate hydration before and after the procedure.

There is no need to worry.

Please do write back for follow up queries that you may have.

Regards,

Above answer was peer-reviewed by
 
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 13 hours later
thanks for your reply.it sounds good.
i have more request that can you do some more research on it plz ask your XXXXXXX doctors about it too.i am not in any hurry. i can wait for your answer.

that will be a great help.

Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 26 hours later
Rt testicula vein can be seen on ct venogram and it has diameter around 3 or 3.5mm in abdomen and pelvis above the XXXXXXX inguinal ring.but it divides into 2 or 3 branches in the inguinal canal.my question is that can these 2 or 3 brances be seen in inguinal canal separetely and clearly on ct venogram performed on 64 or 128 mdct ct scanner?

i asked another radiologist and he said yes these can be seen as separate branhes in the inginal canal.i asked you last time and you were not sure about it.can you consult your XXXXXXX radiologists about it and do some more work on it. i can wait for your answer.

2)In patients with vericocele surgeons ligate testicular vein with sutures.if ct venogram is perfomed on that patient how would that ligation appear on ct venogram?will it appear as a small occlusion of testicular vein or small filling defect or small gap?

my email address is YYYY@YYYY
 
 
Answered by Dr. Ranjeet Jagdale 2 hours later
Hi,

Sure I certainly would like to help you. Give me time of couple of days and I will consult my XXXXXXX radiologists and get back to you.

Regards
Above answer was peer-reviewed by
 
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 5 days later
follow up question for dr ranjeet jagdale, radiologist,panjim,goa,india

1)hi,sir how are you?did you get answers for my questions?

plus can you tell me that what is the protocole of ct venogram perfomed to see testicular veins?how much and what kind of contast material they use?if non ionic or low osmolar contarst material is used does it compromise image quality and saptial resolution of ct venography?

what is the name of test?
ct venography for testicular veins OR ct venogram with study of testicular vein OR abdominopelvic ct venography?

 
 
Answered by Dr. Ranjeet Jagdale 27 hours later
Hi there,
Sorry for the delay.

There is nothing to worry about triggering renal sarcoidosis in patients with pulmonary sarcoidosis. :)

CT venography protocol differs from other only in the timing when you acquire images. As far as contrast is considered it is non ionic low osmolar contrast media which is relatively very safe and gives excellent contrast opacification.

The tributaries of testicular vein in the inguinal canal can be seen separately on routine doppler imaging. I traced the veins on CT in one normal abdomen and they were seen. Doing oblique reformations can demonstrate them better. But if the tributaries are too tortuous(which happens in varicocele) or if there are too many tributaries, then visualizing the tributaries separately may not be possible.

Post ligation it will appear as focal narrowing and cut off at that level.

As far as the name of the test goes, it should be CT venography for testicular veins, but more importantly the imaging planning depends not only on area of interest but also on clinical diagnosis under evaluation.

Hope this helps you
Above answer was peer-reviewed by
 
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 35 hours later
Thanks a lot for your help.Excellent answers.

There is just one thing.
you said tributaries of testicular vein can be seen separately on routine doppler imaging.That is fine.

1)BUT I WANT TO KNOW ABOUT CT SCAN.You said you traced the veins on CT in one normal abdomen.. Were you able to see tributaries of right testicular vein separately in the INGUINAL CANAL from XXXXXXX INGUINAL RING to the SUPERFICIAL INGUINAL RING on CT SCAN?

2)What kind of ct scanner did you use for that?16 slice,64 slice or 128 slice?

 
 
Answered by Dr. Ranjeet Jagdale 34 hours later
Hi,

Yes, we can trace the testicular vein in the inguinal canal but it was not possible to separately identify each of the tributary (generally they are 3-4) within the inguinal canal but were then seen as paired vein along the testicular artery as they ascend upwards over psoas muscles.

We have a 64-slice Phillips CT scanner (Brilliance).

Hope this helps you. If you have no more queries, please accept my answer and write a review.

Thanks,
Above answer was peer-reviewed by
 
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 23 hours later
Tanks sir.i am really satisfied with your answers and already wrote a good review about you.I am a doctor too and i am doing my residency in XXXXXXX Medicine.i got chance to work in radiology departement for 4 months during my house job.

i need advise for my cousin health.He was working in UAE and during his physical checkup doctor found that he had varicocele and laproscopic ligation of testicular vein was done.He was fine after that.
NOW he feels pain in his right testes and we consulted a urologist here.He is a good urologist and he said it is important to check the status of his right testicular vein.was his right testicular vein ligated at that time?Doctor ordered ct venogram to check that.

First surgeon who perfomed laproscopic ligation just mentioned ,laproscopic ligation for varicocele,in his notes.he did not mention about the side right or left.

As we discussed earlier that there will be focal narrowing and cut off at the level of ligation of right testicular vein on ct venogram.

I WANT TO KNOW....
)WHAT OTHER FINDINGS/SIGNS A RADIOLOGIST CAN LOOK FOR ON CT VENOGRAM OF RIGHT TESTICULAR VEIN TO CHECK LIGAATION?
ANY CHANGE IN BLOOD FLOW OR MOVEMENT OF CONTARST MATERIAL?
SOME SPECIAL TECHNIQUE OR MANEUVER WHILE PERFOMING CT SCAN?
VALSALVA MANEUVER?
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 14 minutes later
IN LAPROSCOPIC LIGATION FOR VERICOCELE THEY LIGATE TESTICULAR VEIN IN PELVIC CAVITY ABOUT 1 CM ABOVE THE XXXXXXX INGUINAL RING.
 
 
Answered by Dr. Ranjeet Jagdale 9 hours later
Hello,
I will consult with the urologist in the hospital where I work and will get back to you.
And having a right side varicocoele is less likely than the left sided. Anyways I will talk with the urologist and the exact surgical technique used .
Regards
Above answer was peer-reviewed by
 
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 3 hours later
thanks for your reply.
sorry i think i could not explain my question.there is no need to talk to urologist.i have already consulted a urologist and i know the exact surgical technique as i told you they ligate testicular vein in pelvis above the XXXXXXX inguinal ring.

I know if his testicular vein was ligated at that time and we perform ct venogram now there will be focal narrowing and cut off at the level of ligation.

MY QUESTION IS THAT WILL THERE BE ANY OTHER FINDINGS EXCEPT FOCAL NARROWING?
ANY CHANGE IN FLOW OR MOVEMENT OF CONTRAST MATERIAL?
IS THERE ANY OTHER INFORMATION WE CAN LOOK FOR or ANY TECHNIQUE WE CAN USE WHILE PERFOMING CT SCAN?

 
 
Answered by Dr. Ranjeet Jagdale 19 hours later
Hi,

There will be change in flow dynamics but that cannot be picked up by CT , as it’s a static imaging.

Performing a valsalva will help to distend the veins and, a prominent vein will be easier to trace.

I would rather suggest a Doppler evaluation to asses for the flow dynamics and to grade the varicocoele.Or one can go for venography which will be invasive but a gold standard to assess vessels.

Hope this helps.

Regards,
Above answer was peer-reviewed by
 
Follow-up: If a patient has pulmonary sarcoidosis but no renal involvement, can it affect the kidneys? 4 days later
hi,
can testicular vein and its branches in pelvis and abdomen seen clearly on TC99m scintigraphy?

can testicular vein and its branches seen separately and more clearly on scintigraphy than ct venogram?
 
 
Answered by Dr. Ranjeet Jagdale 1 hour later
Hi,

No, it cannot be seen well on Scintigraphy as that has very poor image resolution and, to see testicular branches CT venography is better than Scinitgraphy.

On scintigraphy, you will be able to see the tracer uptake if there is a reflux or varicocoele but to identify venous tributaries will not be possible.

Hope I have answered your query.

Regards,
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Procedures
Lab Tests
Medical Topics

The user accepted the expert's answer

Ask a Radiologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor