|Hypercalcaemia in patients with sarcoidosis in the South of Ireland
|JL O’Sullivan, LJ Walsh, HI Ibrahim, TM O’Connor
|Mercy University Hospital Cork, Ireland
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Sarcoidosis is a multisystem granulomatous disorder whose prevalence is high in the South of Ireland. Hypercalcaemia has been reported in 10-20% of patients with sarcoidosis at presentation. Increased intestinal calcium absorption induced by high serum calcitriol concentrations is the primary cause and heavy exposure to sunlight is a common precipitant. We sought to determine the prevalence of hypercalcemia in our patients with sarcoidosis.
We reviewed the data of 317 patients with a tissue-proven diagnosis of sarcoidosis who attended Mercy University Hospital, Cork, Ireland from 2005-2021.
Median age was 53y (20-94y), serum calcium was 2.41 mmol/L (1.92-3.1 mmol/L) and serum ACE was 56 IU/L (5-249 IU/L). Hypercalcaemia was present in 6.8% of patients (18/263) at the time of diagnosis, moderate hypercalcaemia (> 3 mmol/L) was present in 0.8% of patients (2/263). Higher serum calcium was associated with younger age (p=0.0229), but no correlations with stage of sarcoidosis, serum ACE, lymphocyte count or vitamin D were seen. There were no differences in serum calcium according to month of diagnosis using non-parametric analysis of variance (p=0.2836).
Despite a high background prevalence of sarcoidosis in the South of Ireland, the prevalence of hypercalcaemia at the time of diagnosis was lower than internationally reported. Moderate or clinically significant hypercalcaemia was rare and seasonal variation had no influence on the level of serum calcium. The temperate climate in our region may explain the lack of seasonal variation in serum calcium in patients with sarcoidosis.