Jayakrishnan B, Al-Mubaihsi Saif M, Kashoub Masoud S, George Jojy
Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2018 Nov;18(4):e533-e536. doi: 10.18295/squmj.2018.18.04.018. Epub 2019 Mar 28.
The coexistence of cystic fibrosis (CF) and sarcoidosis is rare. We report a 22-year-old male cystic fibrosis patient who presented multiple times to the Sultan Qaboos University Hospital, Muscat, Oman, in 2013. He was diagnosed with non-parathyroid-related hypercalcaemia and anterior uveitis, while computed tomography revealed mediastinal and abdominal lymphadenopathy and mild hepatosplenomegaly. These findings, in addition to the presence of calciuria and a high angiotensin-converting enzyme (ACE) level, confirmed a clinical diagnosis of sarcoidosis. The patient responded well to treatment with oral prednisolone which, over the course of two years, resulted in the near-complete resolution of parenchymal nodular infiltrates, regression of hilar lymphadenopathy, resolution of hypercalcaemia and the normalisation of his ACE levels. Diagnosing pulmonary sarcoidosis in CF can be challenging as most adult patients already have extensive lung disease. Physicians should be aware that hypercalcaemia may be an early manifestation of sarcoidosis in such cases.
囊性纤维化（CF）与结节病并存的情况较为罕见。我们报告了一名22岁的男性囊性纤维化患者，该患者于2013年多次前往阿曼马斯喀特的苏丹卡布斯大学医院就诊。他被诊断为非甲状旁腺相关的高钙血症和前葡萄膜炎，同时计算机断层扫描显示纵隔和腹部淋巴结肿大以及轻度肝脾肿大。这些发现，再加上存在高钙尿症和高血管紧张素转换酶（ACE）水平，证实了结节病的临床诊断。该患者对口服泼尼松龙治疗反应良好，在两年的治疗过程中，实质结节浸润几乎完全消退，肺门淋巴结肿大消退，高钙血症得到缓解，ACE水平恢复正常。在CF患者中诊断肺部结节病可能具有挑战性，因为大多数成年患者已经患有广泛的肺部疾病。医生应意识到，在这种情况下高钙血症可能是结节病的早期表现。
