Korean J Med.  2015 Feb;88(2):207-211. 10.3904/kjm.2015.88.2.207.

Case of Sarcoidosis-Related Hypercalcemia with Normal Serum 1,25(OH)2D

• Jeon JH
• Seo JB
• Hwang IR
• Park HY
• Kim JS
• Park KG
• Kim JG

• KMID: 2269154
• DOI: http://doi.org/10.3904/kjm.2015.88.2.207

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.

Keyword

Hypercalcemia; Sarcoidosis; Vitamin D

MeSH Terms

Aged
Biopsy
Calcitriol
Calcium
Humans
Hypercalcemia*
Incidence
Lymph Nodes
Lymphatic Diseases
Male
Prednisone
Sarcoidosis
Vitamin D
Calcitriol
Calcium
Prednisone
Vitamin D