RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000075.xml
PDF herunterladen
Semin Respir Crit Care Med 2002; 23(6): 579-588
DOI: 10.1055/s-2002-36521
DOI: 10.1055/s-2002-36521
Sarcoidosis of the Thyroid and Kidneys and Calcium Metabolism
Weitere Informationen
Publikationsverlauf
Publikationsdatum:
07. Januar 2003 (online)
ABSTRACT
In sarcoidosis, the thyroid and the kidneys are infrequently affected. Clinically recognizable thyroid involvement occurs in < 1% of sarcoidosis patients. Hyperthyroidism, myxodema, and thyroid occur with an equal frequency. It is important to distinguish sarcoidosis of the thyroid from other infections and disorders of the gland.
Renal involvement may present as granulomatous infiltration of the renal parenchyma, glomerulonephritis, renal arteritis, and nephrocalcinosis or renal stones. The latter are due to abnormalities of calcium metabolism.
Hypercalcemia occurs in about 10 to 13% of sarcoidosis patients; hypercalciuria is three times more frequent. Calcium abnormalities may precede, follow, or occur at any time during the course of sarcoidosis. An endogenous overproduction of 1,25-dihydroxyvitamin D [1,25-(OH2)-D3] by granulomatous tissue and activated macrophages results in an increase of intestinal absorption of calcium. Corticosteriods, chloroquine, and hydroxychloroquine subdue 1,25-(OH2)-D3 production and correct hypercalcemia and hypercalciuria.
KEYWORD
Granuloma - hypercalcemia - hypercalciuria granulomatous nephritis - sarcoidosis
REFERENCES
- 1 Spencer J, Warren S. Boeck s sarcoid: report of a case with clinical diagnosis confirmed at autopsy. Arch Intern Med . 1938; 62 285-288
- 2 Mayock R, Bertrand P, Morrison C. Manifestations of sarcoidosis: analysis of 145 patients with a review of nine series from the literature. Am J. Med . 1963; 35 67-89
- 3 Karlish A, MacGregor G. Sarcoidosis, thyroiditis, and Addisons disease. Lancet . 1970; 2 330-333
- 4 Vogt H. Morbus Besnier-Boeck Schaumann: Klinsche and pathologische anatomische studie. Helio Med Acta . 1949; 25(suppl) S1-S105
- 5 Winnacker J, Becker K, Katz S. Endocrine aspects of sarcoidosis. N Engl J Med . 1968; 278 483-492
- 6 Ricker W, Clark M. Sarcoidosis: A clinico-pathologic review of 300 cases including 22 autopsies. Am J Clin Pathol . 1949; 19 725-749
- 7 Turiaf J, Marland P, Basset F. La sarcoidose du corps-thyroide, a propos d ll cas de sarcoidose kysteque du corps thryoide. An Med Interne . 1969; 120 838-845
- 8 Vailati A, Marena C, Aristia L, et al Sarcoidosis of the thyroid: report of a case and review of the literature. Sarcoidosis . 1993; 10 66-68
- 9 Seinfeld E, Sharma O. The Tass syndrome. Proc Roy Soc Med . 1983; 76 883-885
- 10 Harach H, Williams E. The pathology of granulomatous diseases of the thyroid gland. Sarcoidosis . 1990; 7 19-27
- 11 Weisenhutter C, Sharma O. Is sarcoidosis an autoimmune disease?. <~>Report of four cases and review of the literature. Semin Arthr Rheum . 1979; 9 124-160
- 12 Brun J, Mouriquand C, Combey P. Thryoidite sclereuse d origine sarcoidosique avec myxodeme et fibrose pulomonaire diffuse. Lyon Med . 1959; 201 179-188
- 13 Buckle R. Sarcoid goitre. Proc Roy Soc Med . 1963; 56 611-612
- 14 Richards A. Myxodema reflex as presenting sign in sarcoidosis. Can Med Assoc J . 1962; 96 32-34
- 15 Cowdell R. Sarcoidosis with special reference to diagnosis and prognosis. Q J Med . 1954; 23 29
- 16 Cummins S, Clark D, Gandy T. Boeck s sarcoid of thyroid gland. Arch Pathol . 1951; 51 68-71
- 17 Hancock B, Millard L. Sarcoidosis and thyrotoxicosis: a study of five patients. Br J Dis Chest . 1976; 70 129
- 18 Melman K, Goldberg J. Sarcoidosis and exophthalomos as initial symptom. Am J Med . 1962; 33 158
- 19 Sharma O, Dostanic D. Unilateral proptosis and pleural effusion due to sarcoidosis. Sarcoidosis . 1995; 12 68-70
- 20 Capecchi V, Savorani G, Bacchini P. Sarcoidosis of the thyroid gland. Sarcoidosis Vasc Diffuse Lung Dis . 1997; 14 188-192
- 21 Van Assendelft H W A, Kahlos T. Sarcoidosis of the thyroid gland. Sarcoidosis . 1995; 2 154-156
- 22 Warshawsky M, Shanies H, Rozo A. Sarcoidosis involving the thyroid and pleura. Sarcoidosis Vasc Diffuse Lung Dis . 1997; 14 165-168
- 23 Coplu L, Caglar M, Kisacik F. Sarcoidosis with thyroid involvement. Sarcoidosis Vasc Diffuse Lung Dis . 1997; 14 86-87
- 24 Berger S, Zonszein J, Villanena P. Infectious diseases of the thyroid gland. Rev Infect Dis . 1983; 5 108-122
- 25 Slavin R, Walsh T, Pollack A. Late generalised tuberculosis: a clinical pathologic analysis and comparison of 100 cases in the preantibiotic and antibiotic eras. Medicine . 1980; 59 332-356
- 26 Taillandier J, Faux N, Manigand G. Sarcoidosis et hyperthroidie. Sem Hosp (Paris) . 1982; 58 617-620
- 27 Longcope W, Freiman D. A study of sarcoidosis based on a combined investigation of 160 cases including 30 autopsies from the Johns Hopkins Hospital and MGH. Medicine . 1984; 31 1-37
- 28 Muther R, McCarron D, Bennett W. Renal manifestations of sarcoidosis. Arch Intern Med . 1998; 141 643-645
- 29 Hagege A, Baglin J, Prinseau J. Sarcoidosis disclosed by renal insufficiency (3 cases). Sem Hop Paris . 1983; 59 2823-2826
- 30 Guenel J, Chevet D. Interstitial nephropathies in sarcoidosis: effect of corticosteroid therapy and long-term evolution: retrospective study of 22 cases. . 1988; 9 253-257
- 31 Tateno S, Kobayashi Y. Renal manifestations of sarcoidosis: a review. Nippon Rinsho (Japanese Journal of Clinical Medicine) . 1994; 52 1613-1618
- 32 Sheffield E. Pathology of sarcoidosis. Clin Chest Med . 1997; 18 741-754
- 33 Rizzato G, Colombo P. Nephrolithiasis as a presenting feature of chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis . 1996; 13 167-172
- 34 Gobel V, Kettritz R, Schneider W. The protean face of renal sarcoidosis. J Am Soc Nephrol . 2001; 12 616-623
- 35 Utas C, Dogukan A, Patiroghu T. Granulomatous interstitial nephritis in extrapulmonary sarcoidosis. Clin Nephrol . 1999; 51 252-254
- 36 Schwarz A, Krause P H, Kunzendorf V. The outcome of acute interstitial nephritis: risk factors for the transition from acute to chronic interstitial nephritis. Clin Nephrol . 2000; 154 179-190
- 37 Schwarz A, Krause P H, Keller F. Granulomatous interstitial nephritis after nonsteroidal anti-inflammatory drugs. Am J Nephrol . 1988; 8 410-416
- 38 Marie I, Lecomte F, Leveque H. Granulomatous nephritis as the first manifestation of Whipple disease. Ann Intern Med . 2000; 132 94-95
- 39 Manes M, Molino A, Gaiter A. Isolated renal failure secondary to sarcoidosis. Recenti Progressi in Medicina . 2000; 91 441-443
- 40 Morimoto T, Watanabe K, Kobashi R. Renal sarcoidosis monitored with gallium scintigraphy: report of a case. Gen Med . 2000; 1 23-27
- 41 Dimitriades C, Shetty K, Vehaskari M. Membranous nephropathy associated with childhood sarcoidosis. Pediatr Nephrol . 1999; 13 444-447
- 42 Khan I, Simpson J, Catto G. Membranous nephropathy and granulomatous interstitial nephritis in sarcoidosis. Nephron . 1994; 66 459-461
- 43 Mundlein E, Greten T, Ritz E. Graves disease and sarcoidosis in a patient with minimal glomerulonephritis. Nephrol Dial Transplant . 1996; 11 860-862
- 44 Parry R, Falk C. Minimal change disease in association with sarcoidosis. Nephrol Dial Transplant . 1997; 12 2159-2160
- 45 Quismorio F, Sharma O, Chandor S. Immunopathological studies on the cutaneous lesions in sarcoidosis. Br J Dermatol . 1977; 97 635-642
- 46 Auinger M, Irsigler K, Breiteneder S. Normocalcemic hepatorenal sarcoidosis with crescentic glomerulonephritis. Nephrol Dial Transplant . 1977; 12 1474-1477
- 47 Ahuja T, Mattana J, Valerraman E. Wegeners granulomatosis followed by development of sarcoidosis. Am J Kid Dis . 1996; 28 893-898
- 48 Taylor J, Ansell I. Steroid sensitive nephrotic syndrome and renal impairment in a patient with sarcoidosis. Nephrol Dial Transplant . 1996; 11 355-356
- 49 Nishiki M, Murakami Y, Yamane Y. Steroid-sensitive nephrotic syndrome, sarcoidosis and thyroiditis: a new syndrome. Nephrol Dial Transplant . 1999; 14 2008-2010
- 50 Schmidt R, Bender F, Change W. Sarcoidosis after renal transplant. Transplantation . 1999; 68 1420-1423
- 51 Marinides G, Hajdu I, Gans R. A unique association of renal carcinoma with sarcoid reaction in the kidney. Nephron . 1994; 67 477-480
- 52 Bottone A, Labarbera M, Asadourian A. Renal sarcoidosis coexisting with hypernephroma. Urology . 1993; 41 157-159
- 53 Moder K, Litin S, Gaffey T. Renal cell carcinoma associated with sarcoid-like tissue reaction. Mayo Clin Proc . 1990; 65 1498-1501
- 54 Campbell F, Douglas-Jones A. Sarcoid-like granulomas in primary renal cell carcinoma. Sarcoidosis . 1993; 10 128-131
- 55 Nuther R, McCarron D, Bennett W. Renal manifestations of sarcoidosis. Arch Intern Med . 1981; 141 643-646
- 56 Holick M F, Adams J S. Vitamin D metabolism and biological function. In: Aveoli LV, Krans SM, eds. Metabolic Bone Disease
Philadelphia: WB Saunders 1990: 155-195
MissingFormLabel
- 57 Harrell G T, Fisher S. Blood chemical changes in Boecks sarcoid with particular reference to protein, calcium and phosphotase values. J Clin Invest . 1939; 18 687-693
- 58 Henneman P H, Dempsey E F, Carol E J, Albright F. The causes of hypercalcemia in sarcoidosis and its treatment with cortisone and sodium phytate. J Clin Invest . 1956; 35 1229-1242
- 59 Taylor R L, Lynch Jr J H, Winsor W G. Seasonal influence of sunlight on the hypercalcemia of sarcoidosis. Am J Med . 1963; 35 67-89
- 60 Dent C E. Calcium metabolism in sarcoidosis. Postgrad Med J . 1970; 46 471-473
- 61 Hendrix J Z. The remission of hypercalcemia and hypercalciuria in systemic sarcoidosis by vitamin D depletion. Clin Res . 1963; 11 220-225
- 62 Adams J. Vitamin D metabolite-mediated hypercalcemia. Endocrinol Metab Clin N Am . 1989; 18 765-778
- 63 Bell N H, Stern P H, Pantzer E, Sinha T, DeLuca H. Evidence that increased circulating 25-dihydroxy vitamin D is the probable cause for abnormal calcium metabolism in sarcoidosis. J Clin Invest . 1979; 64 218-225
- 64 Mitchell T H, Stamp T CB, Jenkins J L. Hypercalcemic sarcoidosis in hypoparathyroidism Br Med J . 1983; 1 764-765
- 65 Zimerman J, Holick M F, Silver J. Normocalcemia in a hypothyroid patient with sarcoidosis: evidence for parathyroid hormone independent synthesis of 1,25-dihydroxy vitamin D. Ann Intern Med . 1983; 98 338
- 66 Barbour G L, Cobwin J W, Slatopolsky E, Norman A, Horst R. Hypercalcemia in an anephric patient with sarcoidosis: evidence for extrarenal generation of 1,25-dihydroxy vitamin D. N Engl J Med . 1981; 305 440-443
- 67 Adams J, Sharma O, Gacad M. Metabolism of 25-hydroxy vitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis. J Clin Invest . 1983; 72 1856-1860
- 68 Mason R, Frankel T, Chan Y L. Vitamin D conversion by sarcoid lymph node homogenate. Ann Intern Med . 1984; 100 59-61
- 69 Cadranel J. Vitamin D, endocrine and paracrine mediator in cases of pulmonary granulomatosis. Rev Mal Resp . 1995; 12 119-120
- 70 Bhalla A K, Amento E P, Clemens T L, Holick M, Krane S. Specific high-affinity receptors for 1,25-dihydroxy vitamin D3 in human peripheral blood mononuclear cells, presence in monocytes and induction in T lymphocytes following activation. J Clin Endocrinol Metab . 1983; 57 1308-1310
- 71 Adams J S, Modlin R L, Diz M M, Barnes P. Potentiation of the macrophage 25-hydroxy vitamin D-1 hydroxylation reaction by human pleural effusion fluid. J Clin Endocrinol Metab . 1989; 69 457-460
- 72 Barnes P F, Modlin R L, Bikle D D, Adams J. Transpleural gradient of 1 25-dihydroxy vitamin D in tuberculous pleuritis. J Clin Invest . 1989; 83 1527-1532
- 73 Rigby W F, Noelle R J, Krause K, Fanger M W. The effect of 1,25-dihydroxy vitamin D on human T lymphocyte activation and proliferation: a cell cycle analysis. J Immunol . 1985; 135 2279-2286
- 74 McFadden R G, Vickers K E, Fraher L. Lymphocytes: chemokinetic factors derived from human tonsils: modulation by 1,25-dihydroxyvitamin D3 (calcitriol). Am J Respir Cell Mol Biol . 1991; 4 42-49
- 75 Haq A U. 1 25-Dihydroxy vitamin D3 (calcitriol) suppresses IL-2 induced murine thymocyte proliferation. Thymus . 1986; 8 295-306
- 76 Rigby W, Denome S, Fanger M. Regulation of lymphokine production and human T lymphocyte activation by 1,25-dihydroxy vitamin D3. J Clin Invest . 1987; 79 1659-1664
- 77 Provvedini D M, Tsoukas C D, Deftos L J, Manolagas S C. 1a,25-Dihyroxyvitamin D3binding macromolecules in human β-lymphocytes: effects on immunoglobulin production. J Immunol . 1986; 136 2734-2740
- 78 Sharma O. Hypercalcemia in granulomatous disorders: a clinical review. Cur Opin Pulm Med . 2000; 6 442-447
- 79 McCort J J, Wood R H, Hamilton J B, Ehrlich D E. Sarcoidosis: a clinical and roentgenographic study of 28 proven cases. Arch Intern Med . 1947; 80 293-321
- 80 Cummings M M. Epidemiologic and clinical observations in sarcoidosis. Ann Intern Med. . 1959; 50 879-890
- 81 Scadding J G. The kidney and calcium metabolism in sarcoidosis. In: Scadding JG and Mitchell DN, eds. Sarcoidosis
London: Chapman and Hall Medical 1985: 390413
MissingFormLabel
- 82 Mather G. Calcium metabolism and bone changes in sarcoidosis. Br Med J . 1957; 1 248-253
- 83 Putkonen T, Hannuksela N, Hahme H. Calcium and phosphorus metabolism in sarcoidosis. Acta Med Scand . 1965; 177 327-335
- 84 James D G, Neville E, Siltzbach L E. A worldwide review of sarcoidosis. Ann NY Acad Sci . 1976; 278 321-334
- 85 Cronin C C, Dimnear S F, O Mahony, et al. Precipitation of hypercalcemia in sarcoidosis by foreign sun holidays: report of four cases. Postgrad Med J . 1990; 66 307-309
- 86 Webb A R, Kline L W, Holick W F. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab . 1988; 67 377-378
- 87 Mundy G, Raisz L, Cooper R, Schechter G, Salmon S. Evidence for the secretion of an osteoclast stimulating factor in myeloma. N Engl J Med . 1974; 291 1041-1046
- 88 Broulik P, Votava V, Pacovsky V. The tubular maximun for calcium reabsorption in patients with chronic active thoracic sarcoidosis. Eur Respir J . 1990; 3 447-449
- 89 Sharma O P. Vitamin D, calcium and sarcoidosis. Chest . 1996; 109 535-539
- 90 Adams J S, Diz M M, Sharma O P. Effective reduction in the serum 1,25- dihydroxy vitamin D and calcium concentration in Sarcoidosis: associated hypercalcemia with short course chloroquine therapy. Ann Int Med . 1989; 111 437-438
- 91 Barr-é P E, Gascon-Barr M, Meakins J, Goltzman D. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis. Am J Med . 1987; 82 1259-1262
- 92 O Leary J T, Jones G, Yip A, Lohnes D, Cohanim M, Yendt E R. The effects of chloroquine on serum 1,25-dihydroxy vitamin D and calcium metabolism in sarcoidosis. N Engl J Med . 1986; 315 727-730
- 93 Adams J, Sharma O, Diz M, Endres D. Ketoconazole decreases the serum 1,25-dihydroxy vitamin D and calcium concentration in sarcoidosis associated hypercalcemia. J Clin Endocrinol Metab . 1990; 70 1090-1095
- 94 Ejaz A A, Zabaneh R I, Tiwari P, Nawab Z M, Leehey D J, Ing T S. Ketoconazole in the treatment of recurrent nephrolithiasis associated with sarcoidosis. Nephrol Dial Transplant . 1994; 9 1492-1494
- 95 Sharma O, Alfaro C. Hypercalciuria and renal stones in sarcoidosis patient treated by extracorporal shockwave lithotripsy. Sarcoidosis . 1986; 3 7-9