CTICasesSarcoidosis Presenting with Hypocalcemia
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Imaging findings
Chest radiographs showed reticular or reticulonodular opacities, subtle in the right upper lobe. Comparison with an older radiograph showed new hilar and multiple mediastinal lymph node enlargements. Corresponding CT images showed perilymphatic nodules, nicely subpleural and centrilobular, which are super typical for sarcoidosis, along with the mediastinal and hilar lymphadenopathy.
Key takeaways
This is a classic clinical presentation of sarcoidosis with hypocalcemia. The hypocalcemia is thought to be due to activated macrophages secreting calcitriol (vitamin D related), leading to increased absorption of calcium from the gut. It represents a classic association.
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