1993
DOI: 10.1172/jci116342
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Increased calcium intake does not suppress circulating 1,25-dihydroxyvitamin D in normocalcemic patients with sarcoidosis.

Abstract: Ca absorption is regulated by 1,25(OH)2D, and serum values vary inversely with Ca intake. In sarcoidosis, 1,25(OH)2D is produced by alveolar macrophages in response to y-interferon, and patients may develop hypercalcemia after prolonged exposure to sunlight and increased dermal production of vitamin D3. To determine if increased Ca intake suppresses serum 1,25(OH)2D in normocalcemic patients and to identify those at risk, 17 normal subjects and 11 patients were studied on a metabolic ward for two and one-half … Show more

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Cited by 37 publications
(15 citation statements)
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“…Two factors explain this finding: first, only a fraction of the supplementary calcium supplied with drinking water appeared in the urine; second, these modest increases in calcium excretion were associated with corresponding decreases in oxalate excretion. Concerning the first point, in this study [24], and inverse relationships between calcium intake and calcitriol exist [25]. In this study, calcitriol levels decreased when the supplementary calcium of drinking water was added to a low-calcium diet, and this decrease may have played some part in the reduction of the fractional absorption and urinary excretion of calcium at higher calcium intakes.…”
Section: Discuss10 Nmentioning
confidence: 57%
“…Two factors explain this finding: first, only a fraction of the supplementary calcium supplied with drinking water appeared in the urine; second, these modest increases in calcium excretion were associated with corresponding decreases in oxalate excretion. Concerning the first point, in this study [24], and inverse relationships between calcium intake and calcitriol exist [25]. In this study, calcitriol levels decreased when the supplementary calcium of drinking water was added to a low-calcium diet, and this decrease may have played some part in the reduction of the fractional absorption and urinary excretion of calcium at higher calcium intakes.…”
Section: Discuss10 Nmentioning
confidence: 57%
“…First, hypercalcemic patients with sarcoidosis possess a frankly high or inappropriately elevated serum 1,25 (OH) 2 D concentration, although their serum PTH level is suppressed and their serum phosphate concentration is relatively elevated [21,22]. If 1,25(OH) 2 D synthesis were under the regulation of PTH, phosphate, and 1,25 (OH) 2 D itself, then 1,25(OH) 2 D concentrations in such patients should be low.…”
mentioning
confidence: 99%
“…This extrarenal production of 1,25(OH) 2 D 3 , although not as tightly regulated as in the kidneys, occurs in a substrate-dependent manner [2,5]. A portion of extrarenally produced 1,25(OH) 2 D 3 , taken into systemic blood circulation, probably causes an excess of calcium transport at the small intestine and, at the same time, an excess of bone resorption, which is thought to bring on an imbalance of calcium, hypercalcaemia or hypercalciuria, in patients with sarcoidosis [6][7][8][9][10][11].…”
mentioning
confidence: 99%