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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Hypercalcemia: An Underestimated Value Always Good for a Surprise.

Vincenzo Di Giulio1, Tanja Fusi-Schmidhauser1, Marco Pons1

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Summary

This case study highlights acute isolated muscular sarcoidosis, a rare condition causing severe fatigue and high calcium levels. Prompt steroid treatment led to significant patient improvement and normalized calcium.

Keywords:
HyperkalzämieMyositisSarcoidosisSarkoidosehypercalcemiamyositis

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Area of Science:

  • Internal Medicine
  • Rheumatology
  • Neurology

Background:

  • Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas.
  • Muscular involvement in sarcoidosis is uncommon, often presenting with nonspecific symptoms.
  • Hypercalcemia can be a manifestation of sarcoidosis, necessitating thorough investigation.

Observation:

  • A 62-year-old male presented with severe asthenia and dyspnea.
  • Blood tests revealed marked hypercalcemia, initially prompting suspicion of malignancy.
  • 18F-FDG PET-CT demonstrated widespread muscular metabolic activity, indicative of an inflammatory process.

Findings:

  • Muscle biopsy confirmed non-necrotizing granulomas with multinucleated giant cells.
  • The findings were pathognomonic for acute isolated muscular sarcoidosis.
  • The patient experienced significant clinical improvement and normalization of serum calcium levels following treatment.

Implications:

  • This case underscores the importance of considering sarcoidosis in the differential diagnosis of unexplained hypercalcemia and severe asthenia.
  • Early diagnosis and appropriate management, including high-dose steroid therapy, are crucial for favorable outcomes in muscular sarcoidosis.
  • Highlighting rare presentations of sarcoidosis expands diagnostic awareness in clinical practice.