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Bilateral enlargement of hilar lymph nodes on a chest radiograph was incidentally found in a 63-year-old woman in 1993. She was diagnosed to have sarcoidosis, and had periodic checkups by physicians without medication being prescribed. Thirst and polydipsia had developed a month before admission. On Sept. 10, 2004, she was admitted to our hospital for further examinations because of elevated levels of serum calcium and PTHrP with low PTH. Humoral hypercalcemia of malignancy was suspected, but malignancy was not found after extensive investigations including chest and abdominal CT, endoscopic examinations of gastrointestinal tracts and bone scintigram. Hypercalcemia in sarcoidosis is less common in Japan than in US and Europe, and has been considered to be derived from elevated levels of 1, 25-(OH)2D3. Since there have been few reports in the literatures of sarcoidosis with hypercalcemia caused by elevated levels of serum PTHrP, we herein report a patient with sarcoidosis associated with elevated levels of calcium and PTHrP.
日本サルコイドーシス/肉芽腫性疾患学会の論文