Janssen J A, Pols H A, Baggen M G, Birkenhäger J C
Ned Tijdschr Geneeskd. 1989 Dec 2;133(48):2399-402.
In a 56-year-old man hypercalcaemia and kidney function impairment were the presenting symptoms of sarcoidosis. The diagnosis was supported by the finding of elevated 1,25-dihydroxyvitamin D levels and of a cluster of epithelioid macrophages in aspirated bone marrow. By exclusion of other granulomatous diseases and a favourable reaction of the hypercalcaemia and renal function to treatment with prednisone the diagnosis was confirmed. The relationship between the autonomous extrarenal production of 1,25-dihydroxyvitamin D and the hypercalcaemia is discussed.
在一名56岁男性患者中,高钙血症和肾功能损害是结节病的首发症状。血清1,25 - 二羟维生素D水平升高以及抽吸骨髓中出现上皮样巨噬细胞簇支持了该诊断。通过排除其他肉芽肿性疾病以及高钙血症和肾功能对泼尼松治疗产生良好反应,确诊了结节病。本文讨论了1,25 - 二羟维生素D的肾外自主产生与高钙血症之间的关系。