[A case of pulmonary sarcoidosis associated with severe hypercalcemia].
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.
Third Department of Medicine, Shiga University of Medical Science.
K
K
Shinozaki
D
D
Koya
K
K
Sakamoto
A
A
Kashiwagi
I
I
Yamamoto
R
R
Kikkawa
Y
Y
Shigeta
D000368:Aged; D002117:Calcitriol / Q000097:blood; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000378:metabolism; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology
D011239:Prednisolone; D003404:Creatinine; D002117:Calcitriol; D002118:Calcium