help me clear this concept please - sh4peace

[ArchivalUser]

sorry im late
you means sarcoidosis

[ArchivalUser]

thanks, U really master this concept

[ArchivalUser]

DD

[ArchivalUser]

oops i too late too lol, good question tho (there is a description of the mech behind this posted in the Team Sept post for today) Cheers

[ArchivalUser]

Answer: (D) Sarcoidosis


This patient with a suppressed parathyroid hormone (PTH) level has nonparathyroid hypercalcemia. The only two nonparathyroid causes of hypercalcemia among the choices are sarcoidosis and malignancy. Of these, sarcoidosis is more compatible with the time course necessary to develop a kidney stone. It would be distinctly unusual for a malignant tumor to present with a kidney stone because of the typically rapid onset of hypercalcemia in such disorders. Hypercalcemia occurs in less than 10% of patients with sarcoidosis, but hypercalciuria is more common. Both disorders result from unregulated synthesis of 1,25-dihydroxyvitamin D, the active metabolite of vitamin D, in macrophages of sarcoid granulomas. As a consequence of excess 1,25-dihydroxyvitamin D, intestinal calcium absorption and bone resorption are increased, and the secretion of PTH is suppressed. Vitamin D deficiency could also cause this complex of symptoms.

Hypercalcemia is not part of the syndrome of idiopathic hypercalciuria, and the PTH level is high or at least normal (and therefore inappropriate) in hypercalcemic patients with hyperparathyroidism and familial benign hypocalciuric hypercalcemia. Nephrolithiasis in the patient™s father should be recognized as a common event that does not necessarily bear directly on calcium disorders in his children.

[ArchivalUser]

yes armani i read it good job folks