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. 1998 May;53(5):425–429. doi: 10.1136/thx.53.5.425

Clinical impact of bone and calcium metabolism changes in sarcoidosis

G Rizzato 1
PMCID: PMC1745206  PMID: 9708239

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Selected References

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  1. ALBRIGHT F., CARROLL E. L., DEMPSEY E. F., HENNEMAN P. H. The cause of hypercalcuria in sarcoid and its treatment with cortisone and sodium phytate. J Clin Invest. 1956 Nov;35(11):1229–1242. doi: 10.1172/JCI103378. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. ANDERSON J., HARPER C., DENT C. E., PHILPOT G. R. Effect of cortisone on calcium metabolism in sarcoidosis with hypercalcaemia; possibly antagonistic actions of cortisone and vitamin D. Lancet. 1954 Oct 9;267(6841):720–724. doi: 10.1016/s0140-6736(54)90492-4. [DOI] [PubMed] [Google Scholar]
  3. Abdelwahab I. F., Norman A. Osteosclerotic sarcoidosis. AJR Am J Roentgenol. 1988 Jan;150(1):161–162. doi: 10.2214/ajr.150.1.161. [DOI] [PubMed] [Google Scholar]
  4. Adachi J. D., Bensen W. G., Brown J., Hanley D., Hodsman A., Josse R., Kendler D. L., Lentle B., Olszynski W., Ste-Marie L. G. Intermittent etidronate therapy to prevent corticosteroid-induced osteoporosis. N Engl J Med. 1997 Aug 7;337(6):382–387. doi: 10.1056/NEJM199708073370603. [DOI] [PubMed] [Google Scholar]
  5. Adams J. S., Diz M. M., Sharma O. P. Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis-associated hypercalcemia with short-course chloroquine therapy. Ann Intern Med. 1989 Sep 1;111(5):437–438. doi: 10.7326/0003-4819-111-5-437. [DOI] [PubMed] [Google Scholar]
  6. Adams J. S., Gacad M. A. Characterization of 1 alpha-hydroxylation of vitamin D3 sterols by cultured alveolar macrophages from patients with sarcoidosis. J Exp Med. 1985 Apr 1;161(4):755–765. doi: 10.1084/jem.161.4.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Adams J. S., Sharma O. P., Gacad M. A., Singer F. R. Metabolism of 25-hydroxyvitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis. J Clin Invest. 1983 Nov;72(5):1856–1860. doi: 10.1172/JCI111147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Adams J. S., Singer F. R., Gacad M. A., Sharma O. P., Hayes M. J., Vouros P., Holick M. F. Isolation and structural identification of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis. J Clin Endocrinol Metab. 1985 May;60(5):960–966. doi: 10.1210/jcem-60-5-960. [DOI] [PubMed] [Google Scholar]
  9. Adams J. S. Vitamin D metabolite-mediated hypercalcemia. Endocrinol Metab Clin North Am. 1989 Sep;18(3):765–778. [PubMed] [Google Scholar]
  10. BELL N. H., GILL J. R., Jr, BARTTER F. C. ON THE ABNORMAL CALCIUM ABSORPTION IN SARCOIDOSIS. EVIDENCE FOR INCREASED SENSITIVITY TO VITAMIN D. Am J Med. 1964 Apr;36:500–513. doi: 10.1016/0002-9343(64)90099-3. [DOI] [PubMed] [Google Scholar]
  11. Barbour G. L., Coburn J. W., Slatopolsky E., Norman A. W., Horst R. L. Hypercalcemia in an anephric patient with sarcoidosis: evidence for extrarenal generation of 1,25-dihydroxyvitamin D. N Engl J Med. 1981 Aug 20;305(8):440–443. doi: 10.1056/NEJM198108203050807. [DOI] [PubMed] [Google Scholar]
  12. Bell N. H., Bartter F. C. Studies of 47-Ca metabolism in sarcoidosis: evidence for increased sensitivity of bone to vitamin D. Acta Endocrinol (Copenh) 1967 Jan;54(1):173–180. doi: 10.1530/acta.0.0540173. [DOI] [PubMed] [Google Scholar]
  13. Bell N. H., Stern P. H., Pantzer E., Sinha T. K., DeLuca H. F. Evidence that increased circulating 1 alpha, 25-dihydroxyvitamin D is the probable cause for abnormal calcium metabolism in sarcoidosis. J Clin Invest. 1979 Jul;64(1):218–225. doi: 10.1172/JCI109442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Bia M. J., Insogna K. Treatment of sarcoidosis-associated hypercalcemia with ketoconazole. Am J Kidney Dis. 1991 Dec;18(6):702–705. doi: 10.1016/s0272-6386(12)80613-5. [DOI] [PubMed] [Google Scholar]
  15. Casella F. J., Allon M. The kidney in sarcoidosis. J Am Soc Nephrol. 1993 Mar;3(9):1555–1562. doi: 10.1681/ASN.V391555. [DOI] [PubMed] [Google Scholar]
  16. Curhan G. C., Willett W. C., Rimm E. B., Stampfer M. J. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med. 1993 Mar 25;328(12):833–838. doi: 10.1056/NEJM199303253281203. [DOI] [PubMed] [Google Scholar]
  17. Ejaz A. A., Zabaneh R. I., Tiwari P., Nawab Z. M., Leehey D. J., Ing T. S. Ketoconazole in the treatment of recurrent nephrolithiasis associated with sarcoidosis. Nephrol Dial Transplant. 1994;9(10):1492–1494. [PubMed] [Google Scholar]
  18. Fukase M., Avioli L. V., Birge S. J., Chase L. R. Abnormal regulation of 25-hydroxyvitamin D3-1 alpha-hydroxylase activity by calcium and calcitonin in renal cortex from hypophosphatemic (Hyp) mice. Endocrinology. 1984 Apr;114(4):1203–1207. doi: 10.1210/endo-114-4-1203. [DOI] [PubMed] [Google Scholar]
  19. Fukase M., Birge S. J., Jr, Rifas L., Avioli L. V., Chase L. R. Regulation of 25 hydroxyvitamin D3 1-hydroxylase in serum-free monolayer culture of mouse kidney. Endocrinology. 1982 Mar;110(3):1073–1075. doi: 10.1210/endo-110-3-1073. [DOI] [PubMed] [Google Scholar]
  20. Glass A. R., Cerletty J. M., Elliott W., Lemann J., Jr, Gray R. W., Eil C. Ketoconazole reduces elevated serum levels of 1,25-dihydroxyvitamin D in hypercalcemic sarcoidosis. J Endocrinol Invest. 1990 May;13(5):407–413. doi: 10.1007/BF03350691. [DOI] [PubMed] [Google Scholar]
  21. Harrell G. T., Fisher S. BLOOD CHEMICAL CHANGES IN BOECK'S SARCOID WITH PARTICULAR REFERENCE TO PROTEIN, CALCIUM AND PHOSPHATASE VALUES. J Clin Invest. 1939 Nov;18(6):687–693. doi: 10.1172/JCI101084. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Koide Y., Kugai N., Kimura S., Fujita T., Yamashita N., Hiramoto, Sukegawa J., Ogata E., Yamashita K. Increased 1,25-dihydroxycholecalciferol as a cause of abnormal calcium metabolism in sarcoidosis. J Clin Endocrinol Metab. 1981 Mar;52(3):494–498. doi: 10.1210/jcem-52-3-494. [DOI] [PubMed] [Google Scholar]
  23. LONGCOPE W. T., FREIMAN D. G. A study of sarcoidosis; based on a combined investigation of 160 cases including 30 autopsies from The Johns Hopkins Hospital and Massachusetts General Hospital. Medicine (Baltimore) 1952 Feb;31(1):1–132. [PubMed] [Google Scholar]
  24. Lebacq E., Desmet V., Verhaegen H. Renal involvement in sarcoidosis. Postgrad Med J. 1970 Aug;46(538):526–529. doi: 10.1136/pgmj.46.538.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Lemann J., Jr Composition of the diet and calcium kidney stones. N Engl J Med. 1993 Mar 25;328(12):880–882. doi: 10.1056/NEJM199303253281212. [DOI] [PubMed] [Google Scholar]
  26. Lemire J. M., Adams J. S., Kermani-Arab V., Bakke A. C., Sakai R., Jordan S. C. 1,25-Dihydroxyvitamin D3 suppresses human T helper/inducer lymphocyte activity in vitro. J Immunol. 1985 May;134(5):3032–3035. [PubMed] [Google Scholar]
  27. MURPHY G. P., SCHIRMER H. K. Nephrocalcinosis, urolithiasis and renal insufficiency sarcoidosis. J Urol. 1961 Dec;86:702–706. doi: 10.1016/S0022-5347(17)65251-0. [DOI] [PubMed] [Google Scholar]
  28. Mason R. S., Frankel T., Chan Y. L., Lissner D., Posen S. Vitamin D conversion by sarcoid lymph node homogenate. Ann Intern Med. 1984 Jan;100(1):59–61. doi: 10.7326/0003-4819-100-1-59. [DOI] [PubMed] [Google Scholar]
  29. Meyrier A., Valeyre D., Bouillon R., Paillard F., Battesti J. P., Georges R. Different mechanisms of hypercalciuria in sarcoidosis. Correlations with disease extension and activity. Ann N Y Acad Sci. 1986;465:575–586. doi: 10.1111/j.1749-6632.1986.tb18534.x. [DOI] [PubMed] [Google Scholar]
  30. Montemurro L., Fraioli P., Rizzato G. Bone loss in untreated longstanding sarcoidosis. Sarcoidosis. 1991 Mar;8(1):29–34. [PubMed] [Google Scholar]
  31. Montemurro L., Schiraldi G., Fraioli P., Tosi G., Riboldi A., Rizzato G. Prevention of corticosteroid-induced osteoporosis with salmon calcitonin in sarcoid patients. Calcif Tissue Int. 1991 Aug;49(2):71–76. doi: 10.1007/BF02565124. [DOI] [PubMed] [Google Scholar]
  32. Muther R. S., McCarron D. A., Bennett W. M. Renal manifestations of sarcoidosis. Arch Intern Med. 1981 Apr;141(5):643–645. [PubMed] [Google Scholar]
  33. Neville E., Carstairs L. S., James D. G. Sarcoidosis of bone. Q J Med. 1977 Apr;46(182):215–227. [PubMed] [Google Scholar]
  34. O'Leary T. J., Jones G., Yip A., Lohnes D., Cohanim M., Yendt E. R. The effects of chloroquine on serum 1,25-dihydroxyvitamin D and calcium metabolism in sarcoidosis. N Engl J Med. 1986 Sep 18;315(12):727–730. doi: 10.1056/NEJM198609183151203. [DOI] [PubMed] [Google Scholar]
  35. Omdahl T. J. Modulation of kidney 25-hydroxyvitamin D3 metabolism by 1alpha,25-dihydroxyvitamin D3 in thyroparathyroidectomized rats. Life Sci. 1976 Dec 15;19(12):1943–1947. doi: 10.1016/0024-3205(76)90129-6. [DOI] [PubMed] [Google Scholar]
  36. Papapoulos S. E., Clemens T. L., Fraher L. J., Lewin I. G., Sandler L. M., O'Riordan J. L. 1, 25-dihydroxycholecalciferol in the pathogenesis of the hypercalcaemia of sarcoidosis. Lancet. 1979 Mar 24;1(8117):627–630. doi: 10.1016/s0140-6736(79)91076-6. [DOI] [PubMed] [Google Scholar]
  37. Provvedini D. M., Tsoukas C. D., Deftos L. J., Manolagas S. C. 1,25-dihydroxyvitamin D3 receptors in human leukocytes. Science. 1983 Sep 16;221(4616):1181–1183. doi: 10.1126/science.6310748. [DOI] [PubMed] [Google Scholar]
  38. Reichel H., Koeffler H. P., Barbers R., Norman A. W. Regulation of 1,25-dihydroxyvitamin D3 production by cultured alveolar macrophages from normal human donors and from patients with pulmonary sarcoidosis. J Clin Endocrinol Metab. 1987 Dec;65(6):1201–1209. doi: 10.1210/jcem-65-6-1201. [DOI] [PubMed] [Google Scholar]
  39. Reichel H., Koeffler H. P., Norman A. W. The role of the vitamin D endocrine system in health and disease. N Engl J Med. 1989 Apr 13;320(15):980–991. doi: 10.1056/NEJM198904133201506. [DOI] [PubMed] [Google Scholar]
  40. Reichel H., Koeffler H. P., Tobler A., Norman A. W. 1 alpha,25-Dihydroxyvitamin D3 inhibits gamma-interferon synthesis by normal human peripheral blood lymphocytes. Proc Natl Acad Sci U S A. 1987 May;84(10):3385–3389. doi: 10.1073/pnas.84.10.3385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Reid I. R. Preventing glucocorticoid-induced osteoporosis. N Engl J Med. 1997 Aug 7;337(6):420–421. doi: 10.1056/NEJM199708073370609. [DOI] [PubMed] [Google Scholar]
  42. Rizzato G., Colombo P. Nephrolithiasis as a presenting feature of chronic sarcoidosis: a prospective study. Sarcoidosis Vasc Diffuse Lung Dis. 1996 Sep;13(2):167–172. [PubMed] [Google Scholar]
  43. Rizzato G., Fraioli P., Montemurro L. Nephrolithiasis as a presenting feature of chronic sarcoidosis. Thorax. 1995 May;50(5):555–559. doi: 10.1136/thx.50.5.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Rizzato G., Montemurro L. Reversibility of exogenous corticosteroid-induced bone loss. Eur Respir J. 1993 Jan;6(1):116–119. [PubMed] [Google Scholar]
  45. Rizzato G., Riboldi A., Imbimbo B., Torresin A., Milani S. The long-term efficacy and safety of two different corticosteroids in chronic sarcoidosis. Respir Med. 1997 Sep;91(8):449–460. doi: 10.1016/s0954-6111(97)90109-8. [DOI] [PubMed] [Google Scholar]
  46. Rizzato G., Tosi G., Mella C., Montemurro L., Zanni D., Sisti S. Prednisone-induced bone loss in sarcoidosis: a risk especially frequent in postmenopausal women. Sarcoidosis. 1988 Sep;5(2):93–98. [PubMed] [Google Scholar]
  47. Robinson B. W., McLemore T. L., Crystal R. G. Gamma interferon is spontaneously released by alveolar macrophages and lung T lymphocytes in patients with pulmonary sarcoidosis. J Clin Invest. 1985 May;75(5):1488–1495. doi: 10.1172/JCI111852. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Rohatgi P. K. Radioisotope scanning in osseous sarcoidosis. AJR Am J Roentgenol. 1980 Jan;134(1):189–191. doi: 10.2214/ajr.134.1.189. [DOI] [PubMed] [Google Scholar]
  49. Rottoli P., Gonnelli S., Silitro S., Zacchei F., Fabbrini D., Gennari C., Vagliasindi M. Alterations in calcium metabolism and bone mineral density in relation to the activity of sarcoidosis. Sarcoidosis. 1993 Sep;10(2):161–162. [PubMed] [Google Scholar]
  50. Sambrook P., Birmingham J., Kelly P., Kempler S., Nguyen T., Pocock N., Eisman J. Prevention of corticosteroid osteoporosis. A comparison of calcium, calcitriol, and calcitonin. N Engl J Med. 1993 Jun 17;328(24):1747–1752. doi: 10.1056/NEJM199306173282404. [DOI] [PubMed] [Google Scholar]
  51. Selroos O. Bronchoalveolar lavage and biochemical markers in serum for monitoring disease activity and prognosis of sarcoidosis. Sarcoidosis. 1992 Sep;9(2):145–146. [PubMed] [Google Scholar]
  52. Struys A., Snelder A. A., Mulder H. Cyclical etidronate reverses bone loss of the spine and proximal femur in patients with established corticosteroid-induced osteoporosis. Am J Med. 1995 Sep;99(3):235–242. doi: 10.1016/s0002-9343(99)80154-5. [DOI] [PubMed] [Google Scholar]
  53. Studdy P. R., Bird R., Neville E., James D. G. Biochemical findings in sarcoidosis. J Clin Pathol. 1980 Jun;33(6):528–533. doi: 10.1136/jcp.33.6.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. TAYLOR R. L., LYNCH H. J., Jr, WYSOR W. G., Jr Seasonal influence of sunlight on the hypercalcemia of sarcoidosis. Am J Med. 1963 Feb;34:221–227. doi: 10.1016/0002-9343(63)90055-x. [DOI] [PubMed] [Google Scholar]
  55. Tsoukas C. D., Provvedini D. M., Manolagas S. C. 1,25-dihydroxyvitamin D3: a novel immunoregulatory hormone. Science. 1984 Jun 29;224(4656):1438–1440. doi: 10.1126/science.6427926. [DOI] [PubMed] [Google Scholar]
  56. Turner R. T., Bottemiller B. L., Howard G. A., Baylink D. J. In vitro metabolism of 25-hydroxyvitamin D3 by isolated rat kidney cells. Proc Natl Acad Sci U S A. 1980 Mar;77(3):1537–1540. doi: 10.1073/pnas.77.3.1537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Warner M. Catalytic activity of partially purified renal 25-hydroxyvitamin D hydroxylases from vitamin D-deficient and vitamin D-replete rats. J Biol Chem. 1982 Nov 10;257(21):12995–13000. [PubMed] [Google Scholar]
  58. Waron M., Weissgarten J., Gil I., Yona E., Segal R., Rosenman E., Modai D. Sarcoid nephrocalcinotic renal failure reversed by sodium cellulose phosphate. Am J Nephrol. 1986;6(3):220–223. doi: 10.1159/000167128. [DOI] [PubMed] [Google Scholar]
  59. Zerwekh J. E., Pak C. Y., Kaplan R. A., McGuire J. L., Upchurch K., Breslau N., Johnson R., Jr Pathogenetic role of 1 alpha,25-dihydroxyvitamin D in sarcoidosis and absorptive hypercalciuria: different response to prednisolone therapy. J Clin Endocrinol Metab. 1980 Aug;51(2):381–386. doi: 10.1210/jcem-51-2-381. [DOI] [PubMed] [Google Scholar]

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