Abstract | BACKGROUND: CASE: We describe a case of granulomatous myositis presenting with extreme hypercalcemia of 20.1 mg/dl and generalized weakness that did not resolve despite rapid correction of serum calcium. The disease process was unmasked by cholecalciferol supplementation. Initial search for a malignant process yielded no diagnosis, but an elevated 1,25-dihydroxyvitamin D level, in the setting of a suppressed PTH and undetectable PTHrP, pointed to the presence of excessive 1α-hydroxylase activity. METHODS AND RESULTS: Biopsy of the vastus lateralis muscle showed extensive granulomatous myositis. Immunohistochemical staining for 1α-hydroxylase was localized to the multinucleated giant cells and histiocytes. Musculoskeletal magnetic resonance imaging showed involvement of proximal muscle groups of both thighs and upper limbs. CONCLUSION:
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Authors | Jane Tong Wen Zhang, Charles Chan, Sun Young Kwun, Katherine Ann Benson |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 97
Issue 8
Pg. 2579-83
(Aug 2012)
ISSN: 1945-7197 [Electronic] United States |
PMID | 22639294
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Vitamin D
- 1,25-dihydroxyvitamin D
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Topics |
- Aged
- Female
- Granuloma
(complications)
- Humans
- Hypercalcemia
(etiology, therapy)
- Myositis
(complications)
- Sarcoidosis
(complications)
- Vitamin D
(analogs & derivatives, physiology)
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