Recurrent sarcoid granulomatous nephritis and reactive tuberculin skin test in a renal transplant recipient.

End-stage renal failure developed in a patient with systemic sarcoidosis and granulomatous nephritis. She received a successful cadaveric renal transplant and was doing well for about six years before graft impairment occurred. At that time, her mother was found to have active open pulmonary tuberculosis, and she had a strongly reactive result on tuberculin skin testing. No clinical evidence of tuberculosis or systemic sarcoidosis was noted, but a renal graft biopsy specimen revealed the recurrence of an unusual sarcoid lesion identical to that which had occurred in her native kidney. Her condition responded to high-dose prednisone with improvement in graft function.