Asymptomatic Hypercalcemia and Acute Kidney Injury as Presenting Manifestation of Sarcoidosis: A Case Report

Amritpal Sandhu¹, Randy Aviado², Kevin Dales² and Hanadi Abou Dargham^1,

¹Family Medicine Residency Department, St. Joseph’s Medical Center, Stockton, CA USA

²Medical Student Education, Touro University, Vallejo, CA USA

Cite this paper

Amritpal Sandhu, Randy Aviado, Kevin Dales and Hanadi Abou Dargham. Asymptomatic Hypercalcemia and Acute Kidney Injury as Presenting Manifestation of Sarcoidosis: A Case Report. American Journal of Medical Case Reports. 2021; 9(12):698-701. doi: 10.12691/AJMCR-9-12-9

Abstract

Acute renal failure is rarely associated with the usual presentations of sarcoidosis. Sarcoidosis is associated with hypercalcemia and presents with granulomas within other organs, usually the lungs [1]. We present a case of acute renal failure with hypercalcemia in an African American female patient who was eventually diagnosed with sarcoidosis.

Keywords

sarcoidosis, acute renal failure, hypercalcemia

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	D. Valeyre, A. Prasse, H. Nunes, Y. Uzunhan, P.-Y. Brillet, and J. Muller-Quernheim, “Sarcoidosis,” The Lancet, vol. 383, no. 9923, pp. 1155-1167, 2014.
[2]	B. A. Rybicki, M. Major, J. Popovich Jr., M. J. Maliarik, and M. C. Iannuzzi, “Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization,” American Journal of Epidemiology, vol. 145, no. 3, pp. 234-241, 1997.
[3]	M. F. Holick, “Vitamin D deficiency,” The New England Journal of Medicine, vol. 357, no. 3, pp. 266-281, 2007.
[4]	R. Karnchanasorn, M. Sarikonda, S. Aldasouqi, and V. V. Gossain, “Severe hypercalcemia and acute renal failure: an unusual presentation of sarcoidosis,” Case Reports in Medicine, vol. 2010, Article ID 423659, 5 pages, 2010.
[5]	R. P. Baughman, A. S. Teirstein, M. A. Judson et al., “Clinical characteristics of patients in a case control study of sarcoidosis,” American Journal of Respiratory and Critical Care Medicine, vol. 164, no. 10, pp. 1885-1889, 2001.
[6]	Nunes H, Bouvry D, Soler P, Valeyre D. Sarcoidosis. Orphanet J. Rare Dis. 2007; 2: 46.
[7]	Bergner R, Hoffmann M, Waldherr R, Uppenkamp M. Frequency of kidney disease in chronic sarcoidosis. Sarcoidosis Vasc. Diffuse Lung Dis. 2003; 20: 126-32.
[8]	Mahfoudhi M, Mamlouk H, Turki S, Kheder A. Systemic sarcoidosis complicated of acute renal failure: About 12 cases. Pan. Afr. Med. J. 2015; 22: 75.
[9]	Casella FJ, Allon M. The kidney in sarcoidosis. J. Am. Soc. Nephrol. 1993; 3: 1555-62.
[10]	Ibrik O., Samon R., Roda, A. et al., Sarcoidosis: diagnóstico a partir del estúdio de insuficiencia renal e hipercalcemia. Nefrologia 2011, 31(3):371-372.
[11]	Rizzato G. Extrapulmonary presentation of sarcoidosis. Curr. Opin. Pulm. Med. 2001; 7: 295-7.
[12]	A. S. Morgenthau and M. C. Iannuzzi, “Recent advances in sarcoidosis,” Chest, vol. 139, no. 1, pp. 174-182, 2011.
[13]	M. A. Judson, B. W. Thompson, D. L. Rabin et al., “The diagnostic pathway to sarcoidosis,” Chest, vol. 123, no. 2, pp. 406-412, 2003.
[14]	H. Yanardag, ˇ O. N. Pamuk, and G. E. Pamuk, “Lupus pernio” in sarcoidosis: clinical features and treatment outcomes of 14 patients,” Journal of Clinical Rheumatology, vol. 9, no. 2, pp. 72-76, 2003.
[15]	L. E. Siltzbach, D. G. James, E. Neville et al., “Course and prognosis of sarcoidosis around the world,” The American Journal of Medicine, vol. 57, no. 6, pp. 847-852, 1974.
[16]	Judson M: Extrapulmonary sarcoidosis. Semin Respir Crit Care Med 2007, 28: 83-101.
[17]	Nunes H, Bouvry D, Soler P, Valeyre D. Sarcoidosis. Orphanet J. Rare Dis. 2007; 2: 46.
[18]	Bergner R, Hoffmann M, Waldherr R, Uppenkamp M. Frequency of kidney disease in chronic sarcoidosis. Sarcoidosis Vasc. Diffuse Lung Dis. 2003; 20: 126-32.
[19]	Berliner AR, Haas M, Choi MJ. Sarcoidosis: The nephrologist's perspective. Am. J. Kidney Dis. 2006; 48: 856-70.
[20]	Casella FJ, Allon M. The kidney in sarcoidosis. J. Am. Soc. Nephrol. 1993; 3: 1555-62.
[21]	K. A. Fisher, D. M. Serlin, K. C. Wilson, R. E. Walter, J. S. Berman, and H. W. Farber, “Sarcoidosis-associated pulmonary hypertension: outcome with long-term epoprostenol treatment,” Chest, vol. 130, no. 5, pp. 1481-1488, 2006.
[22]	S. Kim, M. A. Judson, R. Donnino et al., “Cardi sarcoidosis,” American Heart Journal, vol. 157, no. 1, pp. 9-21, 2009.
[23]	C. Kellinghaus, M. Schilling, and P. Ludemann, “Neurosarcoidosis: clinical experience and diagnostic pitfalls, European Neurology, vol. 51, no. 2, pp. 84-88, 2004.
[24]	E. E. Lower and K. L. Weiss, “Neurosarcoidosis,” Clinics in Chest Medicine, vol. 29, no. 3, pp. 475-492, 2008.
[25]	O. P. Sharma, “Vitamin D, calcium, and sarcoidosis,” Chest, vol. 109, no. 2, pp. 535-539, 1996.
[26]	Adams JS, Singer FR, Gacad MA et al. Isolation and structural identification of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis. J. Clin. Endocrinol. Metab. 1985; 60: 960-6.
[27]	Inzucchi SE. Understanding hypercalcemia. Its metabolic basis, signs, and symptoms. Postgrad Med. 2004 Apr; 115(4): 69-70, 73-6.
[28]	Moysés-Neto M, Guimarães FM, Ayoub FH, Vieira-Neto OM, Costa JA, Dantas M. Acute renal failure and hypercalcemia. Ren Fail. 2006; 28(2): 153-9.
[29]	Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1999; 160(2): 736.
[30]	Studdy PR, Bird R. Serum angiotensin converting enzyme in sarcoidosis--its value in present clinical practice. Ann Clin Biochem. 1989; 26 (Pt 1): 13.
[31]	Rajakariar R, Sharples EJ, Raftery MJ, Sheaff M, Yaqoob MM: Sarcoid tubulointerstitial nephritis: long-term outcome and response to corticosteroid therapy. Kidney Int 2006, 70: 165-169.