[Sarcoidosis and hypercalcemia in a patient undergoing hemodialysis].
We report sarcoidosis-related hypercalcemia in a patient undergoing hemodialysis, The patient, a 54-year-old woman, had been undergoing maintenance hemodialysis since 1989. The cause of end-stage renal disease was membranoproliferative glomerulonephritis. The patient was admitted to our hospital in January 2002 for the treatment of hypercalcemia(13.5 mg/dl), which was diagnosed in December 2001. Chest X-ray showed bilateral hilar lymphadenopathy, chest CT scan showed mediastinal lymph node swelling, and Ga-scintigraphy showed abnormal accumulation of gallium in the mediastinum. The patient's intact-PTH was 80-100 pg/ml. ACE(31.4 IU/l) and 1.25(OH)2D3(85 pg/ml) were elevated, and the bronchial lavage fluid CD4/CD8 ratio was slightly elevated. Epitheloid granulomatous tissue was obtained from a subclavian lymph node biopsy. Thus, the patient was diagnosed with sarcoidosis. The hypercalcemia and bilateral hilar lymphadenopathy improved with corticosteroid therapy.
Kuwae
Noriko
N
Department of Nephrology, Nakagami Hospital, Okinawa, Japan.
Oshiro
Yoko
Y
Nakazato
Satoshi
S
D015415:Biomarkers / Q000097:blood; D002117:Calcitriol / Q000097:blood; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D006435:Renal Dialysis; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*
D015415:Biomarkers; D007703:Peptidyl-Dipeptidase A; D002117:Calcitriol