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KMID : 0882420150880020207
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Korean Journal of Medicine
2015 Volume.88 No. 2 p.207 ~ p.2011
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Case of Sarcoidosis-Related Hypercalcemia with Normal Serum 1,25(OH)2D
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Jeon In-Sang
Seo Jung-Bum
Hwang In-Ryang
Park Hye-Yoon
Kim Jeong-Shik
Park Keun-Gyu
Kim Jung-Guk
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Abstract
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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.
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KEYWORD
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Hypercalcemia, Sarcoidosis, Vitamin D
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