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Semin Respir Crit Care Med 2020; 41(05): 618-625
DOI: 10.1055/s-0040-1713009
DOI: 10.1055/s-0040-1713009
Review Article
Balancing Altered Calcium Metabolism with Bone Health in Sarcoidosis
Ying Zhou
1
Department of Respiratory Medicine, Clinical Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
,
Elyse E. Lower
2
Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio
› Author Affiliations
Abstract
Abnormal calcium metabolism in sarcoidosis patients can lead to hypercalcemia, hypercalciuria, and kidney stones. Hypercalcemia in sarcoidosis is usually due to increased activity of 1α-hydroxylase in macrophages of pulmonary granulomata, resulting in low levels of 25-hydroxyvitamin D and high levels of calcitriol. Vitamin D supplementation may be dangerous for some sarcoidosis patients and is recommended only for those with decreased 25-hydroxyvitamin D and reduced or normal calcitriol level. Diagnosis, treatment of osteoporosis, and maintenance of bone health are complex issues for sarcoidosis patients. An approach to diagnosis and treatment of bone fragility is presented.
Publication History
Article published online:
10 August 2020
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
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Reference
- 1 Baughman RP, Janovcik J, Ray M, Sweiss N, Lower EE. Calcium and vitamin D metabolism in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30 (02) 113-120
- 2 Zhou Y, Lower EE, Feng Y, Du S, Li H, Baughman RP. Clinical characteristics of sarcoidosis patients in the United States versus China. Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 209-216
- 3 Cameli P, Gonnelli S, Bargagli E. , et al. The role of urinary calcium and chitotriosidase in a cohort of chronic sarcoidosis patients. Respiration 2020; 99 (03) 207-212
- 4 Ruža I, Lucāne Z. Serum and urinary calcium level in Latvian patients with sarcoidosis. Reumatologia 2018; 56 (06) 377-381
- 5 Sweiss NJ, Lower EE, Korsten P, Niewold TB, Favus MJ, Baughman RP. Bone health issues in sarcoidosis. Curr Rheumatol Rep 2011; 13 (03) 265-272
- 6 Oshagbemi OA, Driessen JHM, Pieffers A. , et al. Use of systemic glucocorticoids and the risk of major osteoporotic fractures in patients with sarcoidosis. Osteoporos Int 2017; 28 (10) 2859-2866
- 7 American College of Rheumatology Ad Hoc Committee on Glucocorticoid-Induced Osteoporosis. Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis: 2001 update. Arthritis Rheum 2001; 44 (07) 1496-1503
- 8 Ponce C, Gujral JS. Renal failure and hypercalcemia as initial manifestations of extrapulmonary sarcoidosis. South Med J 2004; 97 (06) 590-592
- 9 Sodhi A, Aldrich T, Vitamin D. Vitamin D supplementation: not so simple in sarcoidosis. Am J Med Sci 2016; 352 (03) 252-257
- 10 Tebben PJ, Singh RJ, Kumar R. Vitamin D-mediated hypercalcemia: mechanisms, diagnosis, and treatment. Endocr Rev 2016; 37 (05) 521-547
- 11 Judson MA, Costabel U, Drent M. , et al. The WASOG sarcoidosis organ assessment instrument: an update of a previous clinical tool. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31 (01) 19-27
- 12 Baughman RP, Teirstein AS, Judson MA. , et al; Case Control Etiologic Study of Sarcoidosis (ACCESS) research group. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001; 164 (10, Pt 1): 1885-1889
- 13 Brito-Zerón P, Sellarés J, Bosch X. , et al. Epidemiologic patterns of disease expression in sarcoidosis: age, gender and ethnicity-related differences. Clin Exp Rheumatol 2016; 34 (03) 380-388
- 14 Rodrigues SC, Rocha NA, Lima MS. , et al. Factor analysis of sarcoidosis phenotypes at two referral centers in Brazil. Sarcoidosis Vasc Diffuse Lung Dis 2011; 28 (01) 34-43
- 15 Monkawa T, Yoshida T, Hayashi M, Saruta T. Identification of 25-hydroxyvitamin D3 1alpha-hydroxylase gene expression in macrophages. Kidney Int 2000; 58 (02) 559-568
- 16 Adams JS, Gacad MA. Characterization of 1 alpha-hydroxylation of vitamin D3 sterols by cultured alveolar macrophages from patients with sarcoidosis. J Exp Med 1985; 161 (04) 755-765
- 17 Baughman RP, Papanikolaou I. Current concepts regarding calcium metabolism and bone health in sarcoidosis. Curr Opin Pulm Med 2017; 23 (05) 476-481
- 18 Inui N, Murayama A, Sasaki S. , et al. Correlation between 25-hydroxyvitamin D3 1 alpha-hydroxylase gene expression in alveolar macrophages and the activity of sarcoidosis. Am J Med 2001; 110 (09) 687-693
- 19 Kavathia D, Buckley JD, Rao D, Rybicki B, Burke R. Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respir Med 2010; 104 (04) 564-570
- 20 Vidal M, Ramana CV, Dusso AS. Stat1-vitamin D receptor interactions antagonize 1,25-dihydroxyvitamin D transcriptional activity and enhance stat1-mediated transcription. Mol Cell Biol 2002; 22 (08) 2777-2787
- 21 Ramstein J, Broos CE, Simpson LJ. , et al. IFN-γ-producing T-helper 17.1 cells are increased in sarcoidosis and are more prevalent than T-helper type 1 cells. Am J Respir Crit Care Med 2016; 193 (11) 1281-1291
- 22 Saidenberg-Kermanac'h N, Semerano L, Nunes H. , et al. Bone fragility in sarcoidosis and relationships with calcium metabolism disorders: a cross sectional study on 142 patients. Arthritis Res Ther 2014; 16 (02) R78
- 23 Kamphuis LS, Bonte-Mineur F, van Laar JA, van Hagen PM, van Daele PL. Calcium and vitamin D in sarcoidosis: is supplementation safe?. J Bone Miner Res 2014; 29 (11) 2498-2503
- 24 Nakayama K, Fukumoto S, Takeda S. , et al. Differences in bone and vitamin D metabolism between primary hyperparathyroidism and malignancy-associated hypercalcemia. J Clin Endocrinol Metab 1996; 81 (02) 607-611
- 25 Večerić-Haler Ž, Romozi K, Antonič M. , et al. Comparison of the Pharmacological effects of paricalcitol versus calcitriol on secondary hyperparathyroidism in the dialysis population. Ther Apher Dial 2016; 20 (03) 261-266
- 26 Lim V, Clarke BL. Coexisting primary hyperparathyroidism and sarcoidosis cause increased angiotensin-converting enzyme and decreased parathyroid hormone and phosphate levels. J Clin Endocrinol Metab 2013; 98 (05) 1939-1945
- 27 Rúa-Figueroa I, Gantes MA, Erausquin C, Mhaidli H, Montesdeoca A. Vertebral sarcoidosis: clinical and imaging findings. Semin Arthritis Rheum 2002; 31 (05) 346-352
- 28 Ungprasert P, Crowson CS, Matteson EL. Risk of fragility fracture among patients with sarcoidosis: a population-based study 1976-2013. Osteoporos Int 2017; 28 (06) 1875-1879
- 29 Bours S, de Vries F, van den Bergh JPW. , et al. Risk of vertebral and non-vertebral fractures in patients with sarcoidosis: a population-based cohort. Osteoporos Int 2016; 27 (04) 1603-1610
- 30 Yong WC, Upala S, Sanguankeo A. Bone mineral loss and fracture in sarcoidosis: a systematic review and meta-analysis. Arch Rheumatol 2018; 34 (02) 130-140
- 31 Bolland MJ, Wilsher ML, Grey A. , et al. Bone density is normal and does not change over 2 years in sarcoidosis. Osteoporos Int 2015; 26 (02) 611-616
- 32 Zhou Y, Lower EE, Li H, Farhey Y, Baughman RP. Clinical characteristics of patients with bone sarcoidosis. Semin Arthritis Rheum 2017; 47 (01) 143-148
- 33 Montemurro L, Fraioli P, Rizzato G. Bone loss in untreated longstanding sarcoidosis. Sarcoidosis 1991; 8 (01) 29-34
- 34 Khan NA, Donatelli CV, Tonelli AR. , et al. Toxicity risk from glucocorticoids in sarcoidosis patients. Respir Med 2017; 132: 9-14
- 35 Ton FN, Gunawardene SC, Lee H, Neer RM. Effects of low-dose prednisone on bone metabolism. J Bone Miner Res 2005; 20 (03) 464-470
- 36 Canalis E. Mechanisms of glucocorticoid-induced osteoporosis. Curr Opin Rheumatol 2003; 15 (04) 454-457
- 37 Sipahi S, Tuzun S, Ozaras R. , et al. Bone mineral density in women with sarcoidosis. J Bone Miner Metab 2004; 22 (01) 48-52
- 38 Grossman JM, Gordon R, Ranganath VK. , et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 2010; 62 (11) 1515-1526
- 39 Bischoff-Ferrari HA, Willett WC, Orav EJ. , et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 2012; 367 (01) 40-49
- 40 Prentice RL, Pettinger MB, Jackson RD. , et al. Health risks and benefits from calcium and vitamin D supplementation: Women's Health Initiative clinical trial and cohort study. Osteoporos Int 2013; 24 (02) 567-580
- 41 Marshall TG, Marshall FE. Sarcoidosis succumbs to antibiotics--implications for autoimmune disease. Autoimmun Rev 2004; 3 (04) 295-300
- 42 Capolongo G, Xu LH, Accardo M. , et al. Vitamin-D status and mineral metabolism in two ethnic populations with sarcoidosis. J Investig Med 2016; 64 (05) 1025-1034
- 43 Bolland MJ, Wilsher ML, Grey A. , et al. Randomised controlled trial of vitamin D supplementation in sarcoidosis. BMJ Open 2013; 3 (10) e003562
- 44 Saidenberg-Kermanac'h N, Valeyre D, Boissier MC. Vitamin D supplementation in patients treated for sarcoidosis: controversy or consensus?. Joint Bone Spine 2017; 84 (05) 521-523
- 45 Pinheiro MM, Reis Neto ET, Machado FS. , et al. Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women. Rev Saude Publica 2010; 44 (03) 479-485
- 46 Lane NE. Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol 2006; 194 (02) S3-S11
- 47 Coughlan T, Dockery F. Osteoporosis and fracture risk in older people. Clin Med (Lond) 2014; 14 (02) 187-191
- 48 Baughman RP, Field S, Costabel U. , et al. Sarcoidosis in America. Analysis based on health care use. Ann Am Thorac Soc 2016; 13 (08) 1244-1252
- 49 Cozier YC, Berman JS, Palmer JR, Boggs DA, Wise LA, Rosenberg L. Reproductive and hormonal factors in relation to incidence of sarcoidosis in US Black women: the Black Women's Health Study. Am J Epidemiol 2012; 176 (07) 635-641
- 50 Sawahata M, Sugiyama Y, Nakamura Y. , et al. Age-related and historical changes in the clinical characteristics of sarcoidosis in Japan. Respir Med 2015; 109 (02) 272-278
- 51 Miloiković VR, Pesut DP. Clinical and radiographic features of sarcoidosis in menopausal women--the impact on therapeutic approach and prognosis. Vojnosanit Pregl 2010; 67 (01) 13-18
- 52 Buckley L, Humphrey MB. Glucocorticoid-induced osteoporosis. N Engl J Med 2018; 379 (26) 2547-2556
- 53 Patel S, Patel G, Johnson D, Ogunremi L, Barron J. Effect of low dose weekly methotrexate on bone mineral density and bone turnover. Ann Rheum Dis 2003; 62 (02) 186-187
- 54 Mazzantini M, Di Munno O, Incerti-Vecchi L, Pasero G. Vertebral bone mineral density changes in female rheumatoid arthritis patients treated with low-dose methotrexate. Clin Exp Rheumatol 2000; 18 (03) 327-331
- 55 Rolvien T, Creutzfeldt AM, Lohse AW, Amling M. Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy. Lupus 2019; 28 (06) 790-793
- 56 Zonneveld IM, Bakker WK, Dijkstra PF, Bos JD, van Soesbergen RM, Dinant HJ. Methotrexate osteopathy in long-term, low-dose methotrexate treatment for psoriasis and rheumatoid arthritis. Arch Dermatol 1996; 132 (02) 184-187
- 57 Morgan S, Hooper KM, Milne EM, Farquharson C, Stevens C, Staines KA. Azathioprine has a deleterious effect on the bone health of mice with DSS-induced inflammatory bowel disease. Int J Mol Sci 2019; 20 (23) ijms20236085
- 58 Lima CA, Lyra AC, Mendes CMC. , et al. Bone mineral density and inflammatory bowel disease severity. Braz J Med Biol Res 2017; 50 (12) e6374
- 59 Compeyrot-Lacassagne S, Tyrrell PN, Atenafu E. , et al. Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus. Arthritis Rheum 2007; 56 (06) 1966-1973
- 60 Zerbini CAF, Clark P, Mendez-Sanchez L. , et al; IOF Chronic Inflammation and Bone Structure (CIBS) Working Group. Biologic therapies and bone loss in rheumatoid arthritis. Osteoporos Int 2017; 28 (02) 429-446
- 61 Okano T, Koike T, Tada M. , et al. The limited effects of anti-tumor necrosis factor blockade on bone health in patients with rheumatoid arthritis under the use of glucocorticoid. J Bone Miner Metab 2014; 32 (05) 593-600
- 62 Qaseem A, Forciea MA, McLean RM, Denberg TD. ; Clinical Guidelines Committee of the American College of Physicians. Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical Practice Guideline Update From the American College of Physicians. Ann Intern Med 2017; 166 (11) 818-839
- 63 Conley RB, Adib G, Adler RA. , et al. Secondary fracture prevention: consensus clinical recommendations from a multistakeholder coalition. J Orthop Trauma 2020; 34 (04) e125-e141
- 64 Gonnelli S, Rottoli P, Cepollaro C. , et al. Prevention of corticosteroid-induced osteoporosis with alendronate in sarcoid patients. Calcif Tissue Int 1997; 61 (05) 382-385
- 65 Adler RA, Funkhouser HL, Petkov VI, Berger MM. Glucocorticoid-induced osteoporosis in patients with sarcoidosis. Am J Med Sci 2003; 325 (01) 1-6
- 66 Friedrich RE, Blake FA. Avascular mandibular osteonecrosis in association with bisphosphonate therapy: a report on four patients. Anticancer Res 2007; 27 (4A): 1841-1845
- 67 Kuroshima S, Sasaki M, Murata H, Sawase T. Medication-related osteonecrosis of the jaw-like lesions in rodents: a comprehensive systematic review and meta-analysis. Gerodontology 2019; 36 (04) 313-324
- 68 Beth-Tasdogan NH, Mayer B, Hussein H, Zolk O. Interventions for managing medication-related osteonecrosis of the jaw. Cochrane Database Syst Rev 2017; 10 (10) CD012432
- 69 Wan JT, Sheeley DM, Somerman MJ, Lee JS. Mitigating osteonecrosis of the jaw (ONJ) through preventive dental care and understanding of risk factors. Bone Res 2020; 8: 14
- 70 de Molon RS, Shimamoto H, Bezouglaia O. , et al. OPG-Fc but not zoledronic acid discontinuation reverses osteonecrosis of the jaws (ONJ) in mice. J Bone Miner Res 2015; 30 (09) 1627-1640
- 71 Iseri K, Iyoda M, Watanabe M. , et al. The effects of denosumab and alendronate on glucocorticoid-induced osteoporosis in patients with glomerular disease: a randomized, controlled trial. PLoS One 2018; 13 (03) e0193846
- 72 Yanbeiy ZA, Hansen KE. Denosumab in the treatment of glucocorticoid-induced osteoporosis: a systematic review and meta-analysis. Drug Des Devel Ther 2019; 13: 2843-2852
- 73 Papapoulos S, Lippuner K, Roux C. , et al. The effect of 8 or 5 years of denosumab treatment in postmenopausal women with osteoporosis: results from the FREEDOM Extension study. Osteoporos Int 2015; 26 (12) 2773-2783
- 74 Lamy O, Stoll D, Aubry-Rozier B, Rodriguez EG. Stopping denosumab. Curr Osteoporos Rep 2019; 17 (01) 8-15
- 75 Kendler DL, Marin F, Zerbini CAF. , et al. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 2018; 391 (10117): 230-240
- 76 Liu CL, Lee HC, Chen CC, Cho DY. Head-to-head comparisons of bisphosphonates and teriparatide in osteoporosis: a meta-analysis. Clin Invest Med 2017; 40 (03) E146-E157
- 77 Bienaimé F, Prié D, Friedlander G, Souberbielle JC. Vitamin D metabolism and activity in the parathyroid gland. Mol Cell Endocrinol 2011; 347 (1-2): 30-41
- 78 Challal S, Semerano L, Nunes H, Valeyre D, Boissier MC, Saidenberg-Kermanac'h N. Teriparatide for osteoporosis in patients with sarcoidosis: report on risk-benefit ratio in four cases. Joint Bone Spine 2016; 83 (03) 344-345