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Hypercalcaemia: A portent of sarcoidosis in cystic fibrosis.

Authors:
B Jayakrishnan Saif M Al-Mubaihsi Masoud S Kashoub Jojy George

Sultan Qaboos Univ Med J 2018 Nov 28;18(4):e533-e536. Epub 2019 Mar 28.

Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.

The coexistence of cystic fibrosis (CF) and sarcoidosis is rare. We report a 22-year-old male cystic fibrosis patient who presented multiple times to the Sultan Qaboos University Hospital, Muscat, Oman, in 2013. He was diagnosed with non-parathyroid-related hypercalcaemia and anterior uveitis, while computed tomography revealed mediastinal and abdominal lymphadenopathy and mild hepatosplenomegaly. These findings, in addition to the presence of calciuria and a high angiotensin-converting enzyme (ACE) level, confirmed a clinical diagnosis of sarcoidosis. The patient responded well to treatment with oral prednisolone which, over the course of two years, resulted in the near-complete resolution of parenchymal nodular infiltrates, regression of hilar lymphadenopathy, resolution of hypercalcaemia and the normalisation of his ACE levels. Diagnosing pulmonary sarcoidosis in CF can be challenging as most adult patients already have extensive lung disease. Physicians should be aware that hypercalcaemia may be an early manifestation of sarcoidosis in such cases.

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http://dx.doi.org/10.18295/squmj.2018.18.04.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443288PMC
November 2018

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