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Case Reports
. 2015 Jul 9:2015:bcr2015210189.
doi: 10.1136/bcr-2015-210189.

Sarcoidosis-related hypercalcaemia due to production of parathyroid hormone-related peptide

Daniel H van Raalte  1 , Susan M Goorden  2 , Evelien A Kemper  3 , Lodewijk A A Brosens  4 , Reinier W ten Kate  1
Affiliations
Case Reports

Sarcoidosis-related hypercalcaemia due to production of parathyroid hormone-related peptide

Daniel H van Raalte et al. BMJ Case Rep. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BMJ Case Rep. 2015 Sep 14;2015:bcr2015210189corr1. doi: 10.1136/bcr-2015-210189corr1. BMJ Case Rep. 2015. PMID: 26370637 Free PMC article. No abstract available.

Abstract

Hypercalcaemia is frequently observed in patients with sarcoidosis. This is classically attributed to ectopic production of 1,25 dihydroxy vitamin D by sarcoid granulomas. We present a case of sarcoidosis-related hypercalcaemia with normal vitamin D levels. In this patient, production of parathyroid hormone-related peptide (PTHrp) was the cause for sarcoidosis-induced hypercalcaemia. As such, plasma PTHrp levels were increased and bone marrow granulomas stained positively for PTHrp expression. Medium-dose prednisolone treatment improved symptoms of sarcoidosis and normalised serum calcium, and PTHrp concentrations. Thus, production of PTHrp may be the cause for hypercalcaemia in some patients with sarcoidosis.

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Figures

Figure 1
Figure 1
(A) Bone marrow biopsy shows the presence of a non-caseating granuloma (arrow) (H&E stain). (B) Parathyroid hormone-related peptide (PTHrp) immunohistochemistry demonstrating PTHrp expression by the granuloma.
See this image and copyright information in PMC

References

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