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Semin Respir Crit Care Med 2002; 23(6): 579-588
DOI: 10.1055/s-2002-36521
DOI: 10.1055/s-2002-36521
Sarcoidosis of the Thyroid and Kidneys and Calcium Metabolism
Om P. Sharma1 , Violeta Vucinic2- 1Keck School of Medicine, Los Angeles CountyUniversity of Southern California, Los Angeles, California
- 2University of Belgrade School of Medicine, Belgrade, Yugoslavia
Further Information
Publication History
Publication Date:
07 January 2003 (online)
ABSTRACT
In sarcoidosis, the thyroid and the kidneys are infrequently affected. Clinically recognizable thyroid involvement occurs in < 1% of sarcoidosis patients. Hyperthyroidism, myxodema, and thyroid occur with an equal frequency. It is important to distinguish sarcoidosis of the thyroid from other infections and disorders of the gland.
Renal involvement may present as granulomatous infiltration of the renal parenchyma, glomerulonephritis, renal arteritis, and nephrocalcinosis or renal stones. The latter are due to abnormalities of calcium metabolism.
Hypercalcemia occurs in about 10 to 13% of sarcoidosis patients; hypercalciuria is three times more frequent. Calcium abnormalities may precede, follow, or occur at any time during the course of sarcoidosis. An endogenous overproduction of 1,25-dihydroxyvitamin D [1,25-(OH2)-D3] by granulomatous tissue and activated macrophages results in an increase of intestinal absorption of calcium. Corticosteriods, chloroquine, and hydroxychloroquine subdue 1,25-(OH2)-D3 production and correct hypercalcemia and hypercalciuria.
KEYWORD
Granuloma - hypercalcemia - hypercalciuria granulomatous nephritis - sarcoidosis
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