Pathogenetic Role of lα,25-Dihydroxyvitamin D inarcoidosis and Absorptive Hypercalciuria: DifferentResponse to Prednisolone Therapy*

Intestinal hyperabsorption of calcium (Ca) is frequently observed in sarcoidosis and is characteristic of absorptive hypercalciuria (AH). The potential pathogenetic role of la,25-dihydroxyvitamin D [1,25(OH)2D] in these two conditions was sought by a careful assessment of the circulating concentration of this vitamin D metabolite and various measures of Ca metabolism before and after prednisolone therapy. In eight patients with sarcoidosis, prednisolone treatment (50 mg⁄day for 8 days) produced a significant fall in serum 1,25(OH)2D [4.8 ± 1.9 to 3.3 ± 1.0 (SD) ng⁄dl; P < 0.025], concomitant with a significant decrease in the fractional intestinal Ca absorption (a) from 0.58 ± 0.14 to 0.46 ± 0.13 (±SD; P < 0.005). Urinary Ca and serum parathyroid hormone did not change significantly. However, in six patients with AH, prednisolone therapy resulted in a nonsignificant rise in serum 1,25(OH)2D from 3.6 ± 0.7 to 4.4 ± 1.0 ng⁄ dl and no significant fall in a (from 0.73 ± 0.08 to 0.70 ± 0.10). Urinary Ca was si...

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