Case of Sarcoidosis-Related Hypercalcemia with Normal Serum 1,25(OH)2D.
10.3904/kjm.2015.88.2.207
- Author:
Jae Han JEON
1
;
Jung Bum SEO
;
In Ryang HWANG
;
Hye Yoon PARK
;
Jeong Shik KIM
;
Keun Gyu PARK
;
Jung Guk KIM
Author Information
1. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. jugkim@knu.ac.kr
- Publication Type:Case Report
- Keywords:
Hypercalcemia;
Sarcoidosis;
Vitamin D
- MeSH:
Aged;
Biopsy;
Calcitriol;
Calcium;
Humans;
Hypercalcemia*;
Incidence;
Lymph Nodes;
Lymphatic Diseases;
Male;
Prednisone;
Sarcoidosis;
Vitamin D
- From:Korean Journal of Medicine
2015;88(2):207-211
- CountryRepublic of Korea
- Language:English
-
Abstract:
Diagnosing hypercalcemia is often challenging because a wide spectrum of diseases-such as malignancy, granulomatous disease, and primary hyperparathyroidism-should be considered. Sarcoidosis is a rare cause of hypercalcemia. The case of a 77-year-old male presenting with sarcoidosis-associated hypercalcemia whose serum 1,25(OH)2D level was normal is reported here. Despite a normal 1,25(OH)2D level and minimally enlarged hilar lymphadenopathy, the serum angiotensin-converting enzyme (ACE) level was increased. Mediastinoscopic biopsy of the right lower paratracheal lymph node revealed pathological findings compatible with sarcoidosis. Treatment with 30 mg/day oral prednisone was started. Currently, the patient is being treated with a tapered dose of oral prednisone and small doses of vitamin D and calcium. Despite its low incidence, sarcoidosis should be considered a cause of hypercalcemia. The important diagnostic factors are not only serum calcitriol levels but also serum ACE levels and pathological findings.
