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dc.contributor.authorSachdeva, Alok
dc.contributor.authorGoeckeritz, Bruce E
dc.contributor.authorOliver, Alyce M
dc.date.accessioned2010-09-24T22:03:26Z
dc.date.available2010-09-24T22:03:26Z
dc.date.issued2008-08-21en_US
dc.identifier.citationCases J. 2008 Aug 7; 1:72en_US
dc.identifier.issn1757-1626en_US
dc.identifier.pmid18687121en_US
dc.identifier.doi10.1186/1757-1626-1-72en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/140
dc.description.abstractABSTRACT: Hypercalcemia has been widely associated with granulomatous processes. This is due to enhanced extra-renal conversion of calcidiol to calcitriol by activated macrophages within the granuloma. Symptomatic hypercalcemia due to granulomatous disorders is not common, with the incidence in sarcoidosis ranging from 10-20%. Large aggregates of monosodium urate crystals in patients with longstanding chronic tophaceous gout can serve as the inciting antigen for the development of granuloma, but hypercalcemia has not been described in this context. We report a case of symptomatic hypercalcemia due to gouty tophi induced granulomatous inflammation. Long term treatment with immunosuppressants, in addition to bisphosphonates and uric acid lowering therapy, has led to stabilization of serum calcium levels and other lab parameters indicative of granulomatous burden.
dc.rightsThe PMC Open Access Subset is a relatively small part of the total collection of articles in PMC. Articles in the PMC Open Access Subset are still protected by copyright, but are made available under a Creative Commons or similar license that generally allows more liberal redistribution and reuse than a traditional copyrighted work. Please refer to the license statement in each article for specific terms of use. The license terms are not identical for all articles in this subset.en_US
dc.titleSymptomatic hypercalcemia in a patient with chronic tophaceous gout: a case report.en_US
dc.typeJournal Articleen_US
dc.identifier.pmcidPMC2518544en_US
dc.contributor.corporatenameDepartment of Medicineen_US
refterms.dateFOA2019-04-09T16:26:43Z
html.description.abstractABSTRACT: Hypercalcemia has been widely associated with granulomatous processes. This is due to enhanced extra-renal conversion of calcidiol to calcitriol by activated macrophages within the granuloma. Symptomatic hypercalcemia due to granulomatous disorders is not common, with the incidence in sarcoidosis ranging from 10-20%. Large aggregates of monosodium urate crystals in patients with longstanding chronic tophaceous gout can serve as the inciting antigen for the development of granuloma, but hypercalcemia has not been described in this context. We report a case of symptomatic hypercalcemia due to gouty tophi induced granulomatous inflammation. Long term treatment with immunosuppressants, in addition to bisphosphonates and uric acid lowering therapy, has led to stabilization of serum calcium levels and other lab parameters indicative of granulomatous burden.


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