Iwazu Yoshitaka, Kuro-O Makoto, Miura Yutaka, Takeda Shin-Ichi, Yamada Toshiyuki, Nagata Daisuke
Department of Nephrology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Department of Clinical Laboratory Medicine, Tochigi Medical Center Shimotsuga, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Clin Kidney J. 2019 Aug 4;14(1):421-423. doi: 10.1093/ckj/sfz086. eCollection 2021 Jan.
In patients with sarcoidosis, dysregulated calcium metabolism is one of the frequently observed complications. However, little attention has been paid to abnormal phosphate metabolism. Herein we present the case of a 42-year-old Japanese man with renal sarcoidosis who developed acute kidney injury due to hypercalcemia and nephrolithiasis. Laboratory data showed hypercalcemia with a normal serum phosphate level and high serum 1,25-hydroxyvitamin D, fibroblast growth factor 23 (FGF23) and calciprotein particle (CPP) levels. After treatment with oral prednisone and bisphosphonate, the laboratory abnormalities and renal dysfunction were resolved. Thus increases in FGF23 and CPP may indicate disturbed phosphate metabolism in renal sarcoidosis.
在结节病患者中，钙代谢失调是常见的并发症之一。然而，人们对异常磷代谢关注甚少。在此，我们报告一例42岁日本男性肾结节病患者，其因高钙血症和肾结石导致急性肾损伤。实验室检查数据显示血钙升高，血磷水平正常，血清1,25-二羟维生素D、成纤维细胞生长因子23（FGF23）和钙蛋白颗粒（CPP）水平升高。经口服泼尼松和双膦酸盐治疗后，实验室检查异常及肾功能障碍得以缓解。因此，FGF23和CPP升高可能提示肾结节病中存在磷代谢紊乱。
