Frequency of disordered calcium metabolism in sarcoidosis

Israel, Harold L.; Goldstein, Robert A.

doi:10.1136/pgmj.46.538.468

Cited by 3 publications

(2 citation statements)

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“…Hypercalcemia was first recognized in patients with sarcoidosis more than 5 decades ago and has become established as an important manifestation of the disease [11,12]. Autonomously produced 1,25(OH) 2 vitamin D3 from activated macrophages trapped in pulmonary alveoli and inflammatory granulomatous tissue has been considered to be involved in the development and preservation of hypercalcemia [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Tumoral calcinosis associated with hypercalcemia in a patient with chronic renal failure

et al. 2010

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A 56-year-old male with chronic renal failure was admitted to the hospital because of progressive hip pain, appetite loss, general fatigue, and hypercalcemia. Slight pain had developed in the left hip 3 months before the initiation of hemodialysis, which subsequently developed into hyperalgesia. The patient was suspected to have sarcoidosis based on the elevated serum angiotensin-converting enzyme and lysozyme levels, and the ocular finding characterized by punched out chorioretinal scarring, although this could not be confirmed by histological evaluations. There was an abnormal uptake of gallium in the dependent portion of the tumoral calcinosis, which could have suggested either the presence of granulomatous sarcoid tissue within the calcified mass or active calcification associated with an inflammatory reaction. Elevated serum concentrations of 1,25-dihydroxyvitamin D3, which should be implicated in the development of hypercalcemia, promptly decreased after the administration of steroids. Steroid administration subsequently led to a decrease in the serum calcium and relief of the hip pain. This was a rare case of sarcoidosis associated with symptomatic tumoral calcinosis and hypercalcemia. The diagnostic significance of a gallium scan in this case will also be discussed.

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Section: Discussionmentioning

confidence: 99%

Tumoral calcinosis associated with hypercalcemia in a patient with chronic renal failure

et al. 2010

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“…Five patients (5-5%) had hypercalcaemia, persistent in three (3-3%) and transient in two (2-2%). This compares with an incidence of 2-8% for persistent hypercalcaemia in 381 patients reported by Israel and Goldstein (1970) and in 5-3% of 149 cases investigated by Mikhael (1970). Of perhaps greater interest was the presence of initial hypocalcaemia in two patients in one of whom (case 8) treatment with oral calcium was necessary to alleviate symptoms.…”

Section: Discussionmentioning

confidence: 54%

Sarcoidosis with renal involvement

MacSearraigh

Doyle

Twomey

et al. 1978

Postgraduate Medical Journal

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Summary Nine of ninety patients with sarcoidosis were found to have significant renal impairment. Epithelioid granulomata were present in five of eight patients who had renal biopsies and glomerular lesions were present in six. There was close correlation between hypercalcaemia, hyperuricaemia, nephrocalcinosis and creatinine clearance. In one patient, renal sarcoidosis complicated membrano-proliferative glomerulonephritis and one patient died in end-stage renal disease.

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Sarcoidosis

Rasmussen

Neukirch

1976

Journal of Internal Medicine

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In a 10‐year review of the records of 146 young male patients suspected of sarcoidosis on the basis of radiographic intrathoracic changes, the chest X‐ray findings have been analysed in relation to the results of different biopsies. Most of the patients were military men, and almost all were apparently unaffected by the disease. Sixty‐six per cent had bilateral hilar lymphadenopathy (BHL) only, 12% had isolated pulmonary lesions and 22% had both BHL and pulmonary lesions. In all patients at least one biopsy was performed, in most cases a scalene fat pad biopsy and/or a liver biopsy. Epithelioid cell granulomas were demonstrated in 86 biopsies from 64 of the 146 patients. Granulomas were obtained more frequently by scalene fat pad biopsies than by liver biopsies in the same group of patients. During the first 4–5 years of the 10‐year period the scalene fat pad biopsies were done in local anesthesia in different general surgical departments without special experience of this biopsy procedure. In the last 5–6 years the scalene fat pad biopsies were done in general anaesthesia in a head and neck surgical department specially trained in this biopsy technique. Granulomas were obtained more frequently in the latter than in the former group. The highest frequency of granulomas was found among patients with both BHL and pulmonary lesions. Of the 71 patients in whom liver biopsy was performed, 43% had granulomas in the liver. A few patients had signs —although only slight—of liver affection. The results of the different biopsies are discussed in relation to the clinical picture. It is concluded that scalene fat pad biopsy in some cases can still be of some diagnostic aid in patients with radiographic intrathoracic changes suspected of sarcoidosis, although this type

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Frequency of disordered calcium metabolism in sarcoidosis

Cited by 3 publications

References 18 publications

Tumoral calcinosis associated with hypercalcemia in a patient with chronic renal failure

Tumoral calcinosis associated with hypercalcemia in a patient with chronic renal failure

Sarcoidosis with renal involvement

Sarcoidosis

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