M. NOPPEN, M.D.; W. SCHANDEVIJL, M.D.; W. MUSCH; W. VlNCKEN
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To the editor: Although the exact pathogenetic mechanism of hypercalcemia in sarcoidosis remains unknown, several studies (1-3) have suggested that the basic disturbance is an increase in circulating levels of 1,25-dihydroxyvitamin D. Increased levels of this substance are thought to be due to excessive synthesis, reflecting aberrant 1-alpha-hydroxylase activity (3). Sarcoid tissue may be the locus of this ectopic 1-alpha-hydroxylase activity (4). We present a clinical observation supporting the involvement of sarcoid tissue.
A 47-year-old woman was hospitalized in May 1982 for persistent cough and wheezing due to extrinsic asthma. Chest roentgenograms showed an enlargement of the superior mediastinum, and
NOPPEN M, SCHANDEVIJL W, MUSCH W, et al. Sarcoidosis and Hypercalcemia. Ann Intern Med. 1986;105:143–144. doi: 10.7326/0003-4819-105-1-143_3
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Published: Ann Intern Med. 1986;105(1):143-144.
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