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Case Reports in Medicine
Volume 2010 (2010), Article ID 423659, 5 pages
http://dx.doi.org/10.1155/2010/423659
Case Report

Severe Hypercalcemia and Acute Renal Failure: An Unusual Presentation of Sarcoidosis

1Department of Diabetes, Endocrinology & Metabolism, City of Hope, University of California, 1500 East Duarte Road, Duarte, CA 91010, USA
2Department of Internal Medicine - Infectious Diseases, Washington University, Campus Box 8051, St. Louis, MO 63130, USA
3Michigan State University, East Lansing, MI 48824, USA

Received 4 October 2010; Accepted 31 October 2010

Academic Editor: Hermann Wasmuth

Copyright © 2010 Rudruidee Karnchanasorn et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although hypercalcemia is a known metabolic complication of sarcoidosis, it is rarely a presenting manifestation. Long-standing hypercalcemia and hypercalciuria can cause nephrocalcinosis and chronic renal failure. Acute renal failure, although described, is also a rare presentation of patients with sarcoidosis. We describe two patients with sarcoidosis, who presented with severe hypercalcemia and worsening renal function. Parathyroid hormone levels were appropriately suppressed. This led to an extensive search for the cause of hypercalcemia. Finally, after a lymph node biopsy in both cases, a diagnosis of sarcoidosis was established, hypercalcemia resolved, and renal function improved in both cases after administration of prednisone.