Es. Boon et al., ENHANCED PRODUCTION OF CALCITRIOL, AND HYPERCALCEMIA IN A PATIENT WITH SARCOIDOSIS PROVOKED BY DAILY INTAKE OF CALCIOL, European journal of clinical chemistry and clinical biochemistry, 31(10), 1993, pp. 679-681
A case of sarcoidosis is described which presented with hypercalcaemia
and renal insufficiency. Initially, a calciol intoxication was diagno
sed, because a high daily intake was suspected. However, vitamin D3 me
tabolites in the blood revealed normal concentrations of calcidiol, bu
t extremely high concentrations of calcitriol. These features rejected
the first diagnosis and pointed to high endogenous calcitriol product
ion, which may take place in granulomatous diseases. This is caused by
an increased 1-alpha-hydroxylation reaction in activated macrophages.
Eventually, muscle biopsy revealed non-caseating granulomas, confirmi
ng the diagnosis of sarcoidosis.