Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020438 (hypercalciuria)
 2,502 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intestinal hyperabsorption of calcium (Ca) is frequently observed in sarcoidosis and is characteristic of absorptive hypercalciuria (AH). The potential pathogenetic role of 1 alpha,25-dihydroxyvitamin D [1,25(OH)2D] in these two conditions was sought by a careful assessment of the circulating concentration of this vitamin D metabolite and various measures of Ca metabolism before and after prednisolone therapy. In eight patients with sarcoidosis, prednisolone treatment (50 mg/day for 8 days) produced a significant fall in serum 1,25(OH)2D [4.8 +/) 1.9 to 3.3 +/- 1.0 (SD) ng/dl; P less than 0.025], concomitant with a significant decrease in the fracitional intestinal Ca absorption (alpha) from 0.58 +/- to 0.14 to 0.46 +/- 0.13 (+/- SD; P less than 0.005). Urinary Ca and serum parathyroid hormone did not change significantly. However, in six patients with AH, prednisolone therapy resulted in a nonsignificant rise in serum 1,25(OH)2D from 3.6 +/- 0.7 to 4.4 +/- 1.0 ng/dl and no significant fall in alpha (from 0.73 +/- 0.08 to 0.70 +/- 0.10). Urinary Ca was significantly increased in AH patients from 230 +/- 35 to 343 +/- 74 (SD) mg/day (P less than 0.005), while serum parathyroid hormone rose slightly. Serum 1,25(OH)2D and alpha were significantly correlated (r = 0.543; P less than 0.05) for patients with sarcoidosis but not in AH patients. These results suggest that the hyperabsorption of calcium in sarcoidosis is dependent on the serum concentration of 1,25(OH)2D, while in AH it may result from additional vitamin D-independent processes.
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PMID:Pathogenetic role of 1 alpha,25-dihydroxyvitamin D in sarcoidosis and absorptive hypercalciuria: different response to prednisolone therapy. 689 5

Twenty-eight cases of sarcoidosis in children 4 years of age or younger have been reported in the literature, including the case presented herein. These patients may display a distinct aspect of this disease. Half of them are younger than 1 year and all but two are whit. Clinically, they are different from the older children: they lack pulmonary disease, and they predominantly have uveitis, arthritis, and skin rash. The natural history of the disease not only involves chronic arthritis, but has the potential for renal disease secondary to hypercalciuria. Use of adrenocorticosteroids may be effective in these situations, as well as for eye involvement.
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PMID:Sarcoidosis in young children. 705 2

Malignancy is the most common cause of hypercalcemia, which may result from direct involvement of bone or from local or distant production of substances that enhance bone resorption. The recognized incidence of primary hyperparathyroidism has increased greatly since the advent of automated biochemical screening. A single parathyroid adenoma is most frequently the cause. Sarcoidosis commonly results in hypercalciuria but seldom causes sustained hypercalcemia. Increased production of 1,25-dihydroxycholecalciferol leads to hyperabsorption of calcium and enhanced bone resorption.
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PMID:Evaluation of the hypercalcemic patient. 721 54

A 31-year-old woman presented with hypercalcemia, anemia, azotemia, and splenomegaly. Extensive laboratory studies failed to establish the diagnosis, though sarcoidosis seemed likely on the basis of marked hypercalciuria and restrictive lung disease. Conjunctival biopsy showed noncaseating epithelioid granulomas, confirming the clinical diagnosis. Conjunctival biopsy deserves consideration in the evaluation of the patient with unexplained hypercalcemia or other findings suggestive of saroidosis.
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PMID:Conjunctival biopsy in unexplained hypercalcemia. 722 48

Sarcoidosis may involve the kidneys in several ways. Most commonly, aberrations of calcium metabolism, including hypercalcemia, hypercalciuria, and nephrocalcinosis, are responsible for the renal manifestations of sarcoidosis. Granulomatous infiltration of the renal interstitium may also produce severe derangements of renal function. Glomerulonephritis can occur with sarcoidosis, although the pathogenesis remains unclear. Besides renal insufficiency and frank renal failure, nephrotic syndrome, nephrolithiasis, hypertension, and a variety of tubular defects may complicate sarcoidosis. The sensitivity of "sarcoid nephropathy" to corticosteroids usually warrants therapeutic trial.
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PMID:Renal manifestations of sarcoidosis. 722 44

Fifty-six consecutive patients with sarcoidosis, 31 subacute and 25 chronic, were investigated for abnormalities of calcium and phosphate metabolism with particular reference to parathyroid function. No abnormality of serum calcium, phosphate, creatinine or alkaline phosphatase was found. Serum levels of 25-OH cholecalciferol were normal and parathyroid hormone levels were normal in all but one patient. Maximum renal tubular reabsorption capacities for calcium and phosphate (TmCa/GFR, TmP/GFR) in relation to glomerular filtration rate in the fasting state, were abnormal in some patients but this did not correlate with any other abnormality in parathyroid function. There was significant hypercalciuria (greater than 10 mmol calcium per 24 hours) in 7.5% of our patients and this is believed to be due to increased calcium flow.
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PMID:Calcium and phosphate metabolism in sarcoidosis with particular reference to parathyroid function. 725 66

Diffuse osteopenia is not generally recognized as a radiological manifestation of skeletal sarcoidosis. Furthermore, the pathologic correlates of the skeletal abnormalities in sarcoidosis are poorly characterized. We quantitated the histomorphometric parameters of bone formation and resorption in a transiliac crest biopsy specimen from a patient with sarcoidosis, diffuse osteopenia, hypercalcemia, and hypercalciuria, who was treated only intermittently with corticosteroids and thiazides. Peritrabecular granulomas were associated with the histologic features of accelerated bone remodeling, namely: excess osteoid; increased numbers of osteoclasts and osteoblasts; increased osteoclastic resorbing surfaces; and increased bone formation rate. We conclude that the peritrabecular granulomas of skeletal sarcoidosis may result in rapid bone turnover with diffuse osteopenia which may contribute to the abnormalities of mineral metabolism.
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PMID:Skeletal sarcoidosis with osteopenia. 734 92

A 51-year-old man has had absorptive hypercalciuria and corticosteroid-responsive hypercalcemia for at least 12 years. There has been no clinical or laboratory proof of primary hyperparathyroidism, hypervitaminosis D, or other known causes of hypercalcemia and absorptive hypercalciuria. Hypercalciuria as well as the elevated serum level of calcium and 1 alpha, 25(OH)2D fell to normal during treatment with corticosteroids. The disturbed calcium metabolism in this patient is characteristic of that observed in sarcoidosis, but extensive studies have failed to uncover evidence of this condition.
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PMID:Corticosteroid-responsive hypercalcemia with elevated serum 1-alpha, 25 dihydroxyvitamin D. 743 65

We report the results of a retrospective analysis of 120 patients with sarcoidosis admitted for the first time to the Clinical Hospital for Pulmonary Diseases "Jordanovac" from 1982 to 1983. Eighty-two women and 38 men (2,2:1) participated in the study. The most common symptoms at the time of hospitalization were cough (35%), erythema nodosum (32.5%), fever (28.3%) and dyspnea (20.9%). The peripheral lymph nodes were enlarged in 10% of the cases, liver in 10.8%, and spleen in 1.7%. Elevated sedimentation rate was found in 40.8% of the patients, hypercalcemia in 3.6%, and hypercalciuria in 23.4%. Peripheral lymphogenia was present in 59.2% of the patients, and hypergammaglobulinemia in 65.5%. Other biochemical parameters were followed, as well. According to the radiological classification, 65 (54.2%) were classified as belonging to Stage I, 51 (42.5%) as belonging to Stage II, and one as belonging to Stage III at the time of diagnosis. 50.8% of the patients presented with an acute onset of the disease, 37.2% had chronic disease, while 12 (10%) patients were detected accidentally. The diagnosis was based on typical clinical and radiologic features along with histological and/or cytological evidence of granuloma usually provided from the tissue biopsy specimens obtained during bronchoscopy (93.3%). Extrathoracic sarcoidosis most usually involved the liver, skin, joints and peripheral lymph nodes. Fifty-eight of the 120 (48.3%) patients were yielded to spontaneous healing. Twenty-seven patients were followed up from 2 to 6 years, and two (7.4%) patients later showed a chronic form of the disease. Corticosteroid therapy was administered to 62 (51.7%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Characteristics and outcome of pulmonary sarcoidosis]. 817 Feb 75

Hypercalcemia occurs in about 10% of the patients with sarcoidosis; hypercalciuria is about three times more frequent. These abnormalities of calcium metabolism are due to dysregulated production of 1,25-(OH)2-D3 (calcitriol) by activated macrophages trapped in pulmonary alveoli and granulomatous inflammation. Undetected hypercalcemia and hypercalciuria can cause nephrocalcinosis, renal stones, and renal failure. Corticosteroids cause prompt reversal of the metabolic defect. Chloroquine, hydroxychloroqune, and ketoconazole are the drugs that should be used if the patient fails to respond or develops dangerous side effects to corticosteroid therapy.
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PMID:Vitamin D, calcium, and sarcoidosis. 862 Jul 32


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