Hypercalsemiain 32 Y Old Man With Sarcoidosis and Paraplegia

lntroduction:  Hypercalcemia  of  immobilization  is rare,  but  hypercalciuria is more  common  than  hypercalcemia. Hypercalcemia an uncommon presentation of sarcoidosis occ urs in 5 to 10% of patients, but 30 to 50% has hypercalciuria. The cause of hypercalcemia in sarcoidosis is similar to  other granulomatous  diseases, and increased activity of 1 alpha  hydroxylase.Case report: A 32-year-old man with a history of car accident and severe trauma to lumbar spine. High serum calcium was reported (14.6 mg/ dl ) in his laboratory data. Chest computed tomography (CT) scan revealed numerous nodules in parenchyma of both lungs. Chronic non-caseating granulomatous inflammation (more probabyl sarcoidosis) was reported. Predniso lonewas started at adose of 35 mg/ day and 10 days after treatment serum calcium level decreased to normal range.Conclusion: Hypercalcemia has been described in patients with granulomatous disorders, most commonly sarcoidosis. Treatm ent of the hypercalcemia or hypercalciuria in granulomatous disorders is aimed at treatment of the underlying disorder. Moderate -dose glucocorticoid therapyis typically used to treat sarcoidosis. The serum calcium concentration begins to fail in two days, but the full hypocalcemic respo nse may take 7to 10 days depending upon the prednisone dose.

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