Display options
Cite
Baraf L, Abu-Shakra M. METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA. AACE Clin Case Rep. 2020;6(6):e311-e314doi: 10.4158/ACCR-2020-0120.
Baraf, L., & Abu-Shakra, M. (2020). METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA. AACE clinical case reports, 6(6), e311-e314. https://doi.org/10.4158/ACCR-2020-0120
Baraf, Lior, and Abu-Shakra, Mahmoud. "METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA." AACE clinical case reports vol. 6,6 (2020): e311-e314. doi: https://doi.org/10.4158/ACCR-2020-0120
Baraf L, Abu-Shakra M. METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA. AACE Clin Case Rep. 2020 Aug 06;6(6):e311-e314. doi: 10.4158/ACCR-2020-0120. eCollection 2020. PMID: 33244491; PMCID: PMC7685419.
Copy Download .nbib Format: NLM
Share it on

AACE Clin Case Rep. 2020 Aug 06;6(6):e311-e314. doi: 10.4158/ACCR-2020-0120. eCollection 2020.

METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA.

AACE clinical case reports

Lior Baraf, Mahmoud Abu-Shakra

PMID: 33244491 PMCID: PMC7685419 DOI: 10.4158/ACCR-2020-0120

Abstract

OBJECTIVE: To present a patient with sarcoidosis-induced hypercalcemia who responded to methotrexate (MTX).

METHODS: The described case includes clinical and biochemical reports.

RESULTS: A 65-year-old woman presented with bilateral hilar lymphadenopathy and pulmonary nodules. Her calcium and phosphorous levels were 11.4 mg/dL and 3.5 mg/dL, respectively. Blood levels of 25-hydroxyvitamin D and parathyroid hormone were 68 nmol/L and 23 pg/dL, respectively. A diagnosis of sarcoidosis was confirmed by a lymph node biopsy that revealed non-caseating granulomas. Prednisone therapy was efficacious in normalizing the calcium level. However, hypercalcemia recurred when the prednisone dosage was tapered to below15 mg daily. Following initiation of MTX at 15 mg/week, prednisone levels were successfully titrated to 3 mg daily. After a temporary withdrawal of MTX therapy, calcium levels increased dramatically to 17 mg/dL.

CONCLUSION: MTX can be used as treatment for sarcoidosis-induced hypercalcemia.

Copyright © 2020 AACE.

Conflict of interest statement

DISCLOSURE The authors have no multiplicity of interest to disclose.

References

  1. Indian J Nephrol. 2013 Sep;23(5):375-7 - PubMed
  2. Thorax. 1999 Aug;54(8):742-6 - PubMed
  3. Sarcoidosis Vasc Diffuse Lung Dis. 2012 Mar;29(1):51-2 - PubMed
  4. Intern Emerg Med. 2018 Apr;13(3):325-331 - PubMed
  5. Am J Kidney Dis. 1991 Dec;18(6):702-5 - PubMed
  6. N Engl J Med. 2007 Nov 22;357(21):2153-65 - PubMed
  7. Lancet. 2014 Mar 29;383(9923):1155-67 - PubMed
  8. Ann Intern Med. 1963 Oct;59:554-64 - PubMed
  9. Nat Rev Rheumatol. 2016 Dec;12(12):731-742 - PubMed
  10. Rheumatology (Oxford). 2000 Jul;39(7):707-13 - PubMed
  11. J Bone Miner Res. 2010 Jul;25(7):1695-9 - PubMed
  12. RMD Open. 2017 Jul 13;3(1):e000365 - PubMed

Publication Types