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Occurrence With Sarcoidosis With End-Stage Renal Disease

John K. Maesaka, MD; Vecihi Batuman, MD; Narcisa C. Pablo, MD; Shobha, MD

Arch Intern Med. 1982;142(6):1206-1207.

Abstract
• It is generally agreed that the kidneys are the only site of 1-hydroxylation of vitamin D and that the abnormal calcium metabolism in sarcoidosis is caused by increased production of 1,25-dihydroxyvitamin D (1,25-[OH]₂D). We describe a patient with sarcoidosis with hypercalcemic nephropathy and end-stage renal disease undergoing long-term maintenance hemodialysis who was initially seen with hypercalcemia and elevated serum levels of 1,25-(OH)₂D. Prednisone administration resulted in decreased serum calcium and 1,25-(OH)₂D levels. These results confirm the recent evidence for extrarenal production of 1,25-(OH)₂D in sarcoidosis and illustrate the importance of altered vitamin D metabolism in the development of hypercalcemia in sarcoidosis.

(Arch Intern Med 1982;142:1206-1207)

Author Affiliations
From the Medical Service, Renal Section, Veterans Administration Medical Center, East Orange, NJ (Drs Maesaka, Batuman, and Shakamuri); College of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark (Drs Maesaka, Batuman, and Shakamuri); and the Department of Medicine, Rockland (NY) County Health and Hospitals (Dr Pablo).

Footnotes
Accepted for publication Jan 18, 1982.

Reprint requests to Chief, Renal Section (111), VA Medical Center, East Orange, NJ 07019 (Dr Maesaka).

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