SARCOID-LIKE GRANULOMATOUS MYOSITIS-ASSOCIATED HYPERCALCEMIA. AN INFREQUENT CASE TO CONSIDER

No Thumbnail Available
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
PTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13.4 mg/dl) following a trip to the Caribbean. The evaluation showed a suppressed PTH, 25-hydroxy vitamin D of 7.5 ng/ml, F-18-FDG PET/CT showed markedly increased uptake in intercostal, back, shoulder, buttock and thigh muscles and a deltoid biopsy confirmed extensive granulomatous myositis. He was prescribed glucocorticoids which resulted in normalized plasma calcium levels and complete recovery from tetraparesis. Sarcoid-like granulomatous myositis should be incorporated into the differential diagnosis of PTH-independent hypercalcemia, especially in the absence of clinical features of sarcoidosis and with special emphasis on the use of F-18-FDG PET/CT to ensure a correct approach.
Description
Keywords
hypercalcemia, sarcoid-like granulomatous myositis, granulomatous disease
Citation