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Normocalcemia in a Hypoparathyroid Patient with Sarcoidosis: Evidence for Parathyroid-Hormone-Independent Synthesis of 1,25 Dihydroxyvitamin D

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▸Request for reprints should be addressed to Justin Silver, M.D.; Department of Nephrology, Hadassah Hospital, P.O.B. 12000; Jerusalem, Israel.

Hadassah University Hospital; Jerusalem,Israel. Massachusetts General Hospital; Boston, Massachusetts

Ann Intern Med. 1983;98(3):338. doi:10.7326/0003-4819-98-3-338
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Sarcoidosis may lead to hypercalcemia due to the increased levels of serum 1,25 dihydroxyvitamin D (1,25(OH)2D) (1). This biologically active metabolite of vitamin D is produced by 1 α hydroxylation of 25 hydroxy vitamin D in the kidneys (2), a reaction normally stimulated by parathyroid hormone (PTH). A patient with postoperative hypoparathyroidism developed sarcoidosis and an elevated serum 1,25(OH)2D level, resulting in a prolonged remission of hypocalcemia.

A 49-year old woman was hospitalized in May 1978 because of fever and precordial pain. The patient had had a subtotal thyroidectomy in 1953 for a diffuse, nontoxic goiter. She later developed tetany,


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