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Sarcoidosis commonly presents in young adults with bilateral hilar lymphadenopathy, lung parenchymal disease and/or skin lesions. Ocular symptoms are the presenting feature in up to 10% of cases, but eye involvement can be demonstrated in around a quarter of all patients. Renal disease is much rarer, and may manifest with hypercalcaemic nephropathy, granulomatous interstitial nephritis, tubular dysfunction or glomerulonephritis. Eye and renal involvement are rarely found together, and may be confused with Wegener's granulomatosis or polyarteritis. We report a case of a young man who developed renal failure due to sarcoidosis soon after presenting with uveitis. The case illustrates an unusual combination of systemic features that may not be widely recognized.