Calcium abnormalities in sarcoidosis
Extrarenal synthesis of calcitriol results from the acquisition by blood monocytes and granuloma macrophages of the ability to convert 25-hydroxy vitamin D3 into 1,25 dihydroxy vitamin D3 (1).
This produces:
- hypercalcaemia in about 11% of patients
- hypercalciuria in up to 40% of patients
- renal calculi in 10% of patients (1)
Intrarenal calcium deposition may result in renal calculi, nephrocalcinosis, interstitial nephritis and renal failure (2).
Hence 24-hour urinary excretion of calcium should be measured in all patients with sarcoidosis (1).
Reference:
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