Sarcoidosis in a chronic dialysis patient diagnosed by sarcoidosis-related hypercalcemia with no common systemic clinical manifestations: a case report and review of the literature

Intern Med. 2013;52(23):2639-44. doi: 10.2169/internalmedicine.52.1075.

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown origin. We herein report a case of sarcoidosis in a chronic dialysis patient diagnosed by hypercalcemia without any common clinical manifestations. The onset of sarcoidosis in chronic dialysis patients is rare; to the best of our knowledge, only 23 cases have been reported. Evaluation of the 23 previously published cases revealed that a diagnosis of sarcoidosis was often achieved by the presence of sarcoidosis-related hypercalcemia without any common clinical presentations, as in the present case. This characteristic may arise from a specific immune deficiency and the unique physiology of 1,25-dihydroxyvitamin D3, a main cause of sarcoidosis-related hypercalcemia, in chronic dialysis patients. These clinical features may be useful to understand the pathogenesis of sarcoidosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Calcitriol / metabolism
  • Gallium Radioisotopes
  • Humans
  • Hypercalcemia / etiology*
  • Hypercalcemia / metabolism
  • Male
  • Radionuclide Imaging
  • Renal Dialysis* / adverse effects
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis
  • Sarcoidosis / diagnostic imaging

Substances

  • Gallium Radioisotopes
  • Calcitriol