Leidig P, Baum H P, Krakamp B, Finke K, Bönner G
Medizinische Klinik I, Städtische Krankenanstalten Köln-Merheim.
Dtsch Med Wochenschr. 1988 Dec 23;113(51-52):2003-6. doi: 10.1055/s-2008-1067927.
Sarcoidosis of the kidneys and liver without radiologically demonstrable lung involvement in a 44-year-old woman was shown to be the cause of a hypercalcaemia syndrome. The hypercalcaemia was presumably due to an increased production of 1,25-(OH)2-vitamin D3 which--like the increased angiotensin converting enzyme--is produced in the epithelioid and giant cells. Corticoid treatment normalized serum calcium and ACE levels and improved renal function. These observations demonstrate that measurement of ACE and 1,25-(OH)2-vitamin D3 levels is helpful in the differential diagnosis of hypercalcaemia, in view of the possibility of sarcoidosis, and should be among the diagnostic tests.
一名44岁女性,肾脏和肝脏患有结节病,影像学检查未显示肺部受累,这被证明是高钙血症综合征的病因。高钙血症可能是由于1,25-(OH)2-维生素D3生成增加所致,与血管紧张素转换酶增加一样,它是由上皮样细胞和巨细胞产生的。皮质类固醇治疗使血清钙和ACE水平恢复正常,并改善了肾功能。鉴于存在结节病的可能性,这些观察结果表明,检测ACE和1,25-(OH)2-维生素D3水平有助于高钙血症的鉴别诊断,应作为诊断检查项目之一。