VITAMIN-D, CALCIUM, AND SARCOIDOSIS

Hypercalcemia occurs in about 10% of the patients with sarcoidosis; hy percalciuria is about three times more frequent. These abnormalities o f calcium metabolism are due to dysregulated production of 1,25-(OH)(2 )-D-3 (calcitriol) by activated macrophages trapped in pulmonary alveo li and granulomatous inflammation. Undetected hypercalcemia and hyperc alciuria can cause nephrocalcinosis, renal stones, and renal failure. Corticosteriods cause prompt reversal of the metabolic defect. Chloroq uine, hydroxychloroqune, and ketoconazole are the drugs that should be used if the patient fails to respond or develops dangerous side effec ts to corticosteroid therapy.