[A case of pulmonary sarcoidosis associated with severe hypercalcemia]

Nihon Naibunpi Gakkai Zasshi. 1994 Jun 20;70(5):503-10. doi: 10.1507/endocrine1927.70.5_503.
[Article in Japanese]

Abstract

A 71-year-old man with a history of sarcoidosis was admitted to our hospital because of polyuria and polydipsia. On admission, the serum calcium concentration was elevated to 12.7mg/dl, and the creatinine clearance was 28.3ml/min. The initial serum 1,25-dihydroxyvitamin D concentration was 55.0pg/ml, while angiotensin-converting enzyme activity and serum PTH-rP concentration were within the normal range. Radiological studies revealed enlargement of bilateral hilar lymph nodes and a nodular lesion in the right lower lung field. Transbronchial lung biopsy showed noncaseous granuloma consistent with pulmonary sarcoidosis. After oral administration of 20mg prednisolone daily, the serum calcium and 1,25-dihydroxyvitamin D concentration returned to normal, and creatinine clearance was raised to 55ml/min. In conclusion, low dose glucocorticoid administration successfully reduced serum 1,25-dihydroxyvitamin D level with a prompt decrease in serum calcium level in a patient with sarcoidosis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Calcitriol / blood
  • Calcium / blood
  • Creatinine / metabolism
  • Humans
  • Hypercalcemia / blood
  • Hypercalcemia / etiology*
  • Kidney / physiopathology
  • Male
  • Prednisolone / therapeutic use
  • Sarcoidosis, Pulmonary / complications*
  • Sarcoidosis, Pulmonary / drug therapy
  • Sarcoidosis, Pulmonary / physiopathology

Substances

  • Prednisolone
  • Creatinine
  • Calcitriol
  • Calcium