Effect of cortisone on hypercalcemia in sarcoidosis. Relief of gastrointestinal, dermatological, and renal symptoms with steroid therapy.

Abstract

Cortisone administered to a patient with sarcoidosis and hypercalcemia resulted in unusually sustained clinical improvement. After biopsy had confirmed the diagnosis, a total of only two weeks of steroid therapy sufficed to relieve the gastrointestinal, dermatological, and, to some extent, the renal symptoms associated with hypercalcemia. Laboratory responses paralleled the amelioration of symptoms. For reasons not yet known, the serum calcium level rises in about one of five patients with sarcoidosis. A vitamin D-like action or substance in the gastrointestinal tract of these patients has been postulated. Cortisone seems to equilibrate or inactivate this process. It may also serve as a tool to differentiate the hypercalcemia of sarcoidosis from other hypercalcemic states. Early recognition and prompt treatment are important to prevent irreversible renal complications.