Semin Respir Crit Care Med 2020; 41(05): 618-625
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


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

Publication Date:
10 August 2020 (online)

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