More than 120 years ago, Jonathan Hutchinson recorded the
first case of sarcoidosis,1 which he called “a case of
livid papillary psoriasis.” Hutchinson’s patient presented with
purplish skin lesions and “gout” and later died of renal failure.
The renal failure was attributed to gout, but could have been caused by
persistent hypercalemia, hypercalcuria, or multiple kidney stones due
to sarcoidosis. Despite advances in diagnostic techniques made since
Hutchinson’s time, the problem of distinguishing organ dysfunction due
to sarcoidosis from other causes remains.