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Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report
There are many causes of hypercalcemia, with hyperparathyroidism and malignancy accounting for 90% of cases. Sarcoidosis and the intake of vitamin D supplements may also cause hypercalcemia, although the occurrence rate is low if only one is involved. We herein report a sarcoidosis patient who devel...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542661/ https://www.ncbi.nlm.nih.gov/pubmed/36221396 http://dx.doi.org/10.1097/MD.0000000000030883 |
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author | Mio, Kimito Haruhara, Kotaro Shimizu, Akihiro Oshiro, Kentaro Kawai, Rena Ikeda, Masato Yokoo, Takashi |
author_facet | Mio, Kimito Haruhara, Kotaro Shimizu, Akihiro Oshiro, Kentaro Kawai, Rena Ikeda, Masato Yokoo, Takashi |
author_sort | Mio, Kimito |
collection | PubMed |
description | There are many causes of hypercalcemia, with hyperparathyroidism and malignancy accounting for 90% of cases. Sarcoidosis and the intake of vitamin D supplements may also cause hypercalcemia, although the occurrence rate is low if only one is involved. We herein report a sarcoidosis patient who developed hypercalcemia after taking cholecalciferol (vitamin D supplement) for a year. PATIENT CONCERN: A 62-year-old Japanese man presented with hypercalcemia and acute kidney injury along with symptoms of fatigue and appetite loss while being followed up for sarcoidosis. DIAGNOSES: We determined that a combination of cholecalciferol supplementation and sarcoidosis had led to hypercalcemia for several reasons. First, hypercalcemia had not been noted when this patient had first been admitted due to sarcoidosis-related respiratory failure several years earlier, which we presumed that was the highest sarcoidosis disease activity. Second, low serum 25-OH Vit.D(3) and high 1,25-(OH)(2) Vit.D(3) levels were noted despite cholecalciferol supplementation for a year, suggesting that 1-α-hydroxylase overexpression caused by sarcoidosis accelerated the conversion from 25-OH Vit.D(3) to 1,25-(OH)(2) Vit.D(3). INTERVENTIONS: Although initially resistant to preservative management, the hypercalcemia promptly improved after starting corticosteroid treatment. OUTCOMES: Hypercalcemia and acute kidney injury were normalized after corticosteroid treatment. LESSONS: We should be aware of patients’ medications, especially in patients with granulomatosis disease. The concomitant measurement of 25-OH Vit.D(3) and 1,25-(OH)(2) Vit.D(3) levels is useful for determining the cause of hypercalcemia. |
format | Online Article Text |
id | pubmed-9542661 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-95426612022-10-11 Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report Mio, Kimito Haruhara, Kotaro Shimizu, Akihiro Oshiro, Kentaro Kawai, Rena Ikeda, Masato Yokoo, Takashi Medicine (Baltimore) 5200 There are many causes of hypercalcemia, with hyperparathyroidism and malignancy accounting for 90% of cases. Sarcoidosis and the intake of vitamin D supplements may also cause hypercalcemia, although the occurrence rate is low if only one is involved. We herein report a sarcoidosis patient who developed hypercalcemia after taking cholecalciferol (vitamin D supplement) for a year. PATIENT CONCERN: A 62-year-old Japanese man presented with hypercalcemia and acute kidney injury along with symptoms of fatigue and appetite loss while being followed up for sarcoidosis. DIAGNOSES: We determined that a combination of cholecalciferol supplementation and sarcoidosis had led to hypercalcemia for several reasons. First, hypercalcemia had not been noted when this patient had first been admitted due to sarcoidosis-related respiratory failure several years earlier, which we presumed that was the highest sarcoidosis disease activity. Second, low serum 25-OH Vit.D(3) and high 1,25-(OH)(2) Vit.D(3) levels were noted despite cholecalciferol supplementation for a year, suggesting that 1-α-hydroxylase overexpression caused by sarcoidosis accelerated the conversion from 25-OH Vit.D(3) to 1,25-(OH)(2) Vit.D(3). INTERVENTIONS: Although initially resistant to preservative management, the hypercalcemia promptly improved after starting corticosteroid treatment. OUTCOMES: Hypercalcemia and acute kidney injury were normalized after corticosteroid treatment. LESSONS: We should be aware of patients’ medications, especially in patients with granulomatosis disease. The concomitant measurement of 25-OH Vit.D(3) and 1,25-(OH)(2) Vit.D(3) levels is useful for determining the cause of hypercalcemia. Lippincott Williams & Wilkins 2022-10-07 /pmc/articles/PMC9542661/ /pubmed/36221396 http://dx.doi.org/10.1097/MD.0000000000030883 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | 5200 Mio, Kimito Haruhara, Kotaro Shimizu, Akihiro Oshiro, Kentaro Kawai, Rena Ikeda, Masato Yokoo, Takashi Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report |
title | Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report |
title_full | Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report |
title_fullStr | Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report |
title_full_unstemmed | Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report |
title_short | Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report |
title_sort | hypercalcemia worsened after vitamin d supplementation in a sarcoidosis patient: a case report |
topic | 5200 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542661/ https://www.ncbi.nlm.nih.gov/pubmed/36221396 http://dx.doi.org/10.1097/MD.0000000000030883 |
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