因甲状旁腺激素相关肽分泌导致的结节病相关性高钙血症。
Sarcoidosis-related hypercalcaemia due to production of parathyroid hormone-related peptide.
作者信息
van Raalte Daniel H, Goorden Susan M, Kemper Evelien A, Brosens Lodewijk A A, ten Kate Reinier W
机构信息
Department of Internal Medicine, Kennemer Gasthuis, Haarlem, The Netherlands.
Atal Medial Diagnostic Centers, Hoofddorp, The Netherlands.
出版信息
BMJ Case Rep. 2015 Jul 9;2015:bcr2015210189. doi: 10.1136/bcr-2015-210189.
Abstract
Hypercalcaemia is frequently observed in patients with sarcoidosis. This is classically attributed to ectopic production of 1,25 dihydroxy vitamin D by sarcoid granulomas. We present a case of sarcoidosis-related hypercalcaemia with normal vitamin D levels. In this patient, production of parathyroid hormone-related peptide (PTHrp) was the cause for sarcoidosis-induced hypercalcaemia. As such, plasma PTHrp levels were increased and bone marrow granulomas stained positively for PTHrp expression. Medium-dose prednisolone treatment improved symptoms of sarcoidosis and normalised serum calcium, and PTHrp concentrations. Thus, production of PTHrp may be the cause for hypercalcaemia in some patients with sarcoidosis.
摘要
结节病患者常出现高钙血症。传统上认为这是由于结节病肉芽肿异位产生1,25-二羟维生素D所致。我们报告一例维生素D水平正常的结节病相关高钙血症病例。在该患者中，甲状旁腺激素相关肽（PTHrp）的产生是结节病诱发高钙血症的原因。因此，血浆PTHrp水平升高，骨髓肉芽肿PTHrp表达呈阳性染色。中等剂量泼尼松龙治疗改善了结节病症状，使血清钙和PTHrp浓度恢复正常。因此，PTHrp的产生可能是一些结节病患者高钙血症的原因。
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