[Hypercalcemia in sarcoidosis].
Although hypercalcemia has long been recognized as a complication of sarcoidosis, the incidence of hypercalcemia (> or = 11 mg/dl) in Japan is probably less than 5%. 1 alpha, 25(OH)2D3 is the main cause for hypercalcemia in sarcoidosis and overproduced by sarcoid granulomata. Gamma-interferon produced by activated lymphocytes and macrophages plays a major role in the synthesis of 1 alpha, 25(OH)2D3. PTH release is down regulated by high serum concentration of 1 alpha, 25(OH)2D3. Parathyroid hormone related protein may also contribute to the hypercalcemia of sarcoidosis. Treatment of hypercalcemia and hypercalciuria consists of a low calcium diet, adequate hydration, minimization of exposure to sunlight and reducing overproduction of 1 alpha, 25(OH)2D3. Prednisone, 15 to 25 mg/day, is the drug of choice to reduce the overproduction of 1 alpha, 25(OH)2D3.
Katakami
Nobuyuki
N
Department of Pulmonary Diseases, Kobe City General Hospital.
D015536:Down-Regulation; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000628:therapy; D006935:Hypercapnia / Q000209:etiology / Q000628:therapy; D007371:Interferon-gamma / Q000502:physiology; D010281:Parathyroid Hormone / Q000378:metabolism; D011241:Prednisone / Q000008:administration & dosage / Q000494:pharmacology; D012507:Sarcoidosis / Q000150:complications* / Q000378:metabolism; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000096:biosynthesis / Q000502:physiology
C116441:2-methyl-1,25-dihydroxyvitamin D3; D010281:Parathyroid Hormone; D014807:Vitamin D; D007371:Interferon-gamma; D011241:Prednisone