Sharma O P
Department of Pulmonary and Critical Care Medicine, USC School of Medicine, Los Angeles, USA.
Chest. 1996 Feb;109(2):535-9. doi: 10.1378/chest.109.2.535.
Hypercalcemia occurs in about 10% of the patients with sarcoidosis; hypercalciuria is about three times more frequent. These abnormalities of calcium metabolism are due to dysregulated production of 1,25-(OH)2-D3 (calcitriol) by activated macrophages trapped in pulmonary alveoli and granulomatous inflammation. Undetected hypercalcemia and hypercalciuria can cause nephrocalcinosis, renal stones, and renal failure. Corticosteroids cause prompt reversal of the metabolic defect. Chloroquine, hydroxychloroqune, and ketoconazole are the drugs that should be used if the patient fails to respond or develops dangerous side effects to corticosteroid therapy.
结节病患者中约10%会出现高钙血症；高钙尿症的发生率约为高钙血症的三倍。这些钙代谢异常是由于被困在肺泡和肉芽肿性炎症中的活化巨噬细胞产生的1,25-(OH)2-D3（骨化三醇）失调所致。未被发现的高钙血症和高钙尿症可导致肾钙质沉着、肾结石和肾衰竭。皮质类固醇可迅速逆转这种代谢缺陷。如果患者对皮质类固醇治疗无反应或出现危险的副作用，应使用氯喹、羟氯喹和酮康唑。
