Introduction: In patients with sarcoidosis high levels of Ca2+ in blood serum accompanied by increased 24-hour urinary calcium are of great diagnostic and prognostic value. High levels of these two important parameters may point to hyperparathyroidism and/or chronic sarcoidosis. It is necessary to exclude kidney insufficiency by kidney ultrasound.
Material and methods: During the previous four years (1999-2003), urinary Ca was significantly higher than the physiological level in 25 patients, whereas the blood serun Ca was normal. 18 patients received corticosteroid therapy (40 mg for two months, and 35 mg later on). Patients with acute sarcoidosis received prednisone for 11.8 months, while patients with chronic sarcoidosis received it for 13.6 months. One patient with chronic sarcoidosis received methotrexate, as alternative therapy.
Results: 4 months later, after normalization of urinary Ca excretion, the follow-up of patients revealed only one patient with increased urinary Ca excretion associated with increased ACE and radiographic progression of the disease.