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Systemic sarcoidosis presenting as asymptomatic hypercalcaemia.
Sydnie Hom1, Kevin White2, Anna Budina2,3
1Student, Cooper Medical School of Rowan University, Camden, New Jersey, USA sydniehom@gmail.com.
BMJ Case Reports
|July 14, 2026
Summary
This case study highlights an uncommon presentation of sarcoidosis. Persistent hypercalcaemia in a patient with chronic conditions resolved with prednisone, demonstrating sarcoidosis responsiveness to steroids.
Area of Science:
- Internal Medicine
- Pulmonology
- Endocrinology
Background:
- Sarcoidosis is an inflammatory disease characterized by granuloma formation.
- Hypercalcaemia is a potential complication of sarcoidosis, though uncommon as an initial presentation.
- Co-existing conditions like chronic kidney disease, HIV, and type 2 diabetes can complicate diagnosis and management.
Purpose of the Study:
- To report a rare case of sarcoidosis presenting primarily with asymptomatic hypercalcaemia.
- To illustrate the diagnostic challenges and treatment response in such a case.
- To emphasize the importance of considering sarcoidosis in patients with unexplained hypercalcaemia.
Main Methods:
- Case report of a patient with multiple comorbidities.
- Diagnostic workup including laboratory tests and bronchoscopy with lymph node biopsy.
- Therapeutic trial with prednisone for hypercalcaemia management.
Main Results:
- The patient presented with persistent asymptomatic hypercalcaemia and mediastinal lymphadenopathy.
- Biopsy confirmed non-necrotising granulomas, indicative of sarcoidosis.
- Hypercalcaemia resolved with prednisone treatment but recurred upon steroid dose reduction.
Conclusions:
- Sarcoidosis can present unusually with hypercalcaemia as the primary manifestation.
- Early diagnosis and appropriate steroid management are crucial for symptom control.
- This case underscores the need for a broad differential diagnosis in patients with unexplained hypercalcaemia.
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