MEDizzy - A 34-year-old woman has a history of cutaneous sarcoidosis

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A 34-year-old woman has a history of cutaneous sarcoidosis that has been managed with hydroxychloroquine for the last 5 years. After an episode of right flank pain and hematuria, she is diagnosed with renal calculus. Which of the following statements regarding her renal calculus is true?

ExplanationHypercalcemia and/or hypercalciuria occurs in approximately 10% of patients with sarcoidosis and is thought to be due to increased production of 1, 25-dihydroxyvitamin D by the granuloma itself, with resultant increased gut calcium absorption. Sun and exogenous vitamin D can exacerbate the problem. Because of this, renal calculi are relatively common. If a patient with sarcoidosis is to begin therapy with calcium supplementation, 24-hour urine for calcium excretion should be performed before and after initiation of therapy. Often small doses of glucocorticoids are adequate to control this problem.