Life-Threatening Hypercalcemia Revealing Diffuse and Isolated Acute Sarcoid-Like Myositis A New Entity? (A Case-Series)

被引：15

作者：

Mageau, Arthur ^{[1
]}

Rigolet, Aude ^{[2
]}

Benali, Khadija ^{[3
]}

Chauchard, Maria ^{[4
]}

Ladjeroud, Salima ^{[5
]}

Mahe, Isabelle ^{[6
]}

Maisonobe, Thierry ^{[7
]}

Chauveheid, Marie-Paule ^{[1
]}

Papo, Thomas ^{[1
,8
,9
]}

Sacre, Karim ^{[1
,8
,9
]}

机构：

[1] Univ Paris Diderot, PRES Sorbonne Paris Cite, Hop Bichat, Dept Med Interne,Assistance Publ Hop Paris, Paris, France

[2] Univ Paris 06, Hop La Pitie Salpetriere, AP HP, Dept Med Interne,Ctr Reference Pathol Neuromuscul, Paris, France

[3] Univ Paris 06, Hop St Antoine, AP HP, Dept Med Nucl, Paris, France

[4] Univ Paris 06, Hop St Antoine, AP HP, Dept Med Interne, Paris, France

[5] Univ Paris Diderot, PRES Sorbonne Paris Cite, Hop Bichat, Dept Radiol,Assistance Publ Hop Paris, Paris, France

[6] Univ Paris Diderot, PRES Sorbonne Paris Cite, Hop Louis Mourier,Methodol & Soc, Dept Med Interne,Assistance Publ Hop Paris,EA REM, Paris, France

[7] Univ Paris 06, Hop La Pitie Salpetriere, AP HP, Dept Neuropathol & Neurophysiol, Paris, France

[8] Univ Paris Diderot, PRES Sorbonne Paris Cite, Dept Hosp Univ FIRE Fibrosis Inflammat & Remodell, Paris, France

[9] Univ Paris Diderot, PRES Sorbonne Paris Cite, INSERM U1149, Lab Excellence INFLAMEX, Paris, France

来源：

MEDICINE | 2016年 / 95卷 / 10期

关键词：

MUSCLE INVOLVEMENT; MEDIATED HYPERCALCEMIA; MUSCULAR SARCOIDOSIS; IMAGING FINDINGS; CALCITRIOL; PATIENT; CALCIUM;

D O I：

10.1097/MD.0000000000003089

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Up to 50% patients with sarcoidosis display extrapulmonary disease. However, initial and isolated (ie, without lung disease) acute muscular involvement associated with pseudo-malignant hypercalcemia is very uncommon. We report on 3 cases of life-threatening hypercalcemia revealing florid and isolated acute sarcoid-like myositis. All patients complained of fatigue, progressive general muscle weakness, and weight loss. Laboratory tests showed a severe life-threatening hypercalcemia (>3.4 mmol/L). Hypercalcemia was associated with increased serum level of 1,25-(OH)(2) vitamin D and complicated with acute renal failure. One patient displayed acute pancreatitis due to hypercalcemia. In all cases, PET-scan, performed for malignancy screening, incidentally revealed an intense, diffuse, and isolated muscular fluorodeoxyglucose (FDG) uptake consistent with diffuse non-necrotizing giant cells granulomatous myositis demonstrated by muscle biopsy. Of note, creatine phosphokinase blood level was normal in all cases. No patients displayed the usual thoracic features of sarcoidosis. All patients were treated with high dose steroids and achieved rapid, complete, and sustained remission. A review of English and French publications in Medline revealed 5 similar published cases. Steroid-sensitive acute sarcoid-like myositis causing high calcitriol levels and life-threatening hypercalcemia should be recognized as a separate entity.

引用

页数：6

共 33 条

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