Calcitriol-Mediated Hypercalcaemia and Increased Interleukins in a Patient with Sarcoid Myopathy |
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| Authors: | P. Peris J. Font J. M. Grau M. J. Martínez de Osaba X. Filella J. Muñoz-Gómez |
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| Affiliation: | (1) Services of Rheumatology, Hospital Clinic, University of Barcelona, Spain, ES;(2) Internal Medicine, Hospital Clinic, University of Barcelona, Spain, ES;(3) Hormonal Laboratory, Hospital Clinic, University of Barcelona, Spain, ES;(4) Clinical Biochemistry, Hospital Clinic, University of Barcelona, Spain, ES |
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| Abstract: | In this report we describe a patient with Sjo¨gren’s syndrome (SS) and calcitriol-mediated hypercalcaemia. Initially, there was no clinical evidence of sarcoidosis. The patient had hypercalcaemia associated with increased calcitriol serum levels; circulating interleukin-6 and tumour necrosis factor alpha levels were also elevated. At the beginning, therapy with clodronate was effective in decreasing the serum calcium levels. However, the serum calcitriol decreased only after chloroquine treatment was added. After 2 years of therapy, the patient developed progressive and extensive muscle weakness. A muscle biopsy revealed a very prominent non-caseating granulomatous myopathy. Corticosteroid therapy was then instituted. Although both chloroquine and corticosteroid therapy were associated with decreased serum interleukin and calcitriol levels, only corticosteroid therapy was effective in treating the sarcoid myopathy. The role of cytokines in calcitriol mediated hypercalcaemia is discussed. Received: 1 February 1999 / Accepted: 2 June 1999 |
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| Keywords: | :Calcitriol – Chloroquine – Corticosteroid – Cytokines – Hypercalcaemia – Interleukin – Sarcoidosis – Treatment |
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