Department of Respiratory Medicine, Clinical Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio.
Semin Respir Crit Care Med. 2020 Oct;41(5):618-625. doi: 10.1055/s-0040-1713009. Epub 2020 Aug 10.
Abnormal calcium metabolism in sarcoidosis patients can lead to hypercalcemia, hypercalciuria, and kidney stones. Hypercalcemia in sarcoidosis is usually due to increased activity of 1α-hydroxylase in macrophages of pulmonary granulomata, resulting in low levels of 25-hydroxyvitamin D and high levels of calcitriol. Vitamin D supplementation may be dangerous for some sarcoidosis patients and is recommended only for those with decreased 25-hydroxyvitamin D and reduced or normal calcitriol level. Diagnosis, treatment of osteoporosis, and maintenance of bone health are complex issues for sarcoidosis patients. An approach to diagnosis and treatment of bone fragility is presented.
结节病患者的钙代谢异常可导致高钙血症、高钙尿症和肾结石。结节病的高钙血症通常是由于肺肉芽肿巨噬细胞中 1α-羟化酶活性增加，导致 25-羟维生素 D 水平降低和骨化三醇水平升高。维生素 D 补充剂对某些结节病患者可能有危险，仅推荐用于 25-羟维生素 D 降低和骨化三醇水平降低或正常的患者。诊断、骨质疏松症的治疗和骨骼健康的维持是结节病患者的复杂问题。提出了一种诊断和治疗骨脆弱的方法。
