Document Detail


Hypercalcemia in two patients with sarcoidosis and Mycobacterium avium intracellulare not mediated by elevated vitamin D metabolites.
MedLine Citation:
PMID:  21760475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: To describe 2 unusual cases of hypercalcemia due to granulomatous diseases with normal vitamin D metabolites and no other ready explanation for the hypercalcemia.
METHODS: We present the clinical, laboratory and pathologic findings of 2 patients with hypercalcemia and review previous reports of hypercalcemia in granulomatous diseases without elevated vitamin D metabolites.
RESULTS: Hypercalcemia was described in various granulomatous diseases including sarcoidosis, tuberculosis, berylliosis, leprosy and, rarely, in fungal infections. Elevated serum level of vitamin D or its metabolites was linked to the pathogenesis of hypercalcemia in these disorders. The authors present the clinical, laboratory and pathologic findings in 2 patients who presented with hypercalcemia and normal vitamin D metabolites with no other ready explanation for the hypercalcemia. The first patient was diagnosed with Mycobacterium avium, whereas the second patient was found to have sarcoidosis.
CONCLUSION: Although hypercalcemia in granulomatous diseases has been attributed to be mediated by elevated vitamin D metabolites, there have been several case reports that documented normal values of active vitamin D metabolites. This report illustrates the regulatory feedback mechanisms of vitamin D synthesis and introduces the term "inappropriately normal" vitamin D metabolites levels in light of low levels of parathyroid hormone.
Authors:
Muhammad Z Shrayyef; Zsolt DePapp; William T Cave; Steven D Wittlin
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  342     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-28     Completed Date:  2011-11-08     Revised Date:  2011-12-30    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Moncton City Hospital, Moncton, Canada. Dr.Muhammad.Shrayyef@horizonNB.ca
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / complications,  metabolism
Adult
Feedback, Physiological
Granulomatous Disease, Chronic / blood,  complications
Humans
Hypercalcemia / blood*,  etiology*
Male
Middle Aged
Mycobacterium avium-intracellulare Infection / blood*,  complications*
Parathyroid Hormone / blood
Sarcoidosis / blood*,  complications*
Vitamin D / blood*,  metabolism
Chemical
Reg. No./Substance:
0/Parathyroid Hormone; 1406-16-2/Vitamin D
Comments/Corrections
Comment In:
Am J Med Sci. 2011 Dec;342(6):539   [PMID:  22108173 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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