Hypercalcemia of sarcoidosis treated with cellulose sodium phosphate

A patient with pulmonary sarcoidosis and symptomatic hypercalcemia had elevated serum 1,25-dihydroxyvitamin D and angiotensin-converting enzyme levels, with evidence of deterioration of renal function. Pulmonary function tests were normal and there were no other findings to warrant immediate steroid use. She was treated with cellulose sodium phosphate, in an effort to control the hypercalcemia. Serum calcium declined to normal values within 4 weeks and was associated with symptomatic improvement and normalization of BUN and creatinine, indicating perhaps a direct relationship between serum calcium and renal function in this setting. These observations suggest that the hypercalcemia of sarcoidosis may be successfully treated with cellulose sodium phosphate presumably by reducing intestinal calcium absorption, but further clinical trials will be necessary to establish its effectiveness in the long term.