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An Atypical Case of Extrapulmonary Sarcoidosis with Severe Hypercalcemia as Initial Presentation, Successfully Treated with Glucocorticoids

Authors :
Sushmita Mittal
Karolina Pogorzelski
Christopher Huxel
Chokkalingam Siva
Deepthi Rao
Source :
Clinics and Practice, Vol 14, Iss 4, Pp 1264-1269 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Background: Sarcoidosis is a multisystemic disease that is histologically characterized by non-caseating granulomas in one or more organs. Although hypercalcemia is commonly seen in sarcoidosis, clinically significant hypercalcemia as the initial presentation of sarcoidosis is exceedingly rare. Long-standing hypercalcemia can lead to several complications and needs to be adequately managed to prevent irreversible damage. Currently, there are no standard treatment guidelines for sarcoidosis-induced hypercalcemia, although glucocorticoids have often been used as first-line therapy. Case Report: We describe a 55-year-old male patient who presented with dull right upper quadrant abdominal pain and a 30-pound weight loss over one month. He was found to have severe hypercalcemia, which was treated with intravenous (IV) normal saline and intramuscular calcitonin. Imaging studies revealed hypodense lesions throughout the bilateral hepatic lobes, spleen, and bilateral kidneys, with no pathologic mediastinal, hilar, supraclavicular, or axillary lymphadenopathy or pulmonary parenchymal disease. A splenic biopsy confirmed extrapulmonary sarcoidosis. After initial discharge, the patient was re-admitted weeks later for severe hypercalcemia, which was successfully treated with the initiation of prednisone. Conclusions: In this report, we present an atypical case of isolated extrapulmonary sarcoidosis with severe hypercalcemia as the initial presentation, successfully treated with steroids.

Details

Language :
English
ISSN :
20397283
Volume :
14
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Clinics and Practice
Publication Type :
Academic Journal
Accession number :
edsdoj.30cc727c0fb843608e9c778ce8e15cc5
Document Type :
article
Full Text :
https://doi.org/10.3390/clinpract14040102