In a 62-year-old white woman, submitted to preoperative evaluation for facectomy, urinary alterations were detected. The diagnosis established included left-sided kidney stones and homolateral exclusion. At pre-nephrectomy, interstitial widespread lung disease and thoracic adenopathy were evidenced and their investigation was postponed to after surgery. In the removed kidney, non cascous epithelioid granulomas were found. Later, transbronchial biopsy disclosed this same aspect. The patient was treated with methylprednisolone and presented slight pulmonary improvement, though no amelioration in renal function occurred. Final diagnosis was sarcoidosis with lung, thoraco-lymphatic and renal involvement.

Keywords: Sarcoidosis. Kidney failure. Pulmonary sarcoidosis.