Categories: Endocrinology

Hypercalcemia in Granulomatous Disorders: Mechanism

Hypercalcemia can occur in the context of several granulomatous diseases including: Sarcoidosis, Wegener’s granulomatosis, Silicosis, Berylliosis, Tuberculosis, Fungal granulomas and lymphomas.

WHY? Due to pathological up regulation of the conversion of:

Calcidiol (25-hydroxyvitamin D) —> Calcitriol  (1,25-(OH2)D3) via 1-hydroxylase

by activated macrophages within the pulmonary parenchyma and granulomatous inflammation.


  1. Sharma, OP. Hypercalcemia in granulomatous disorders: a clinical review. Curr Opin Pulm Med. 2000 Sep;6(5):442-7.
  2. M. Fuss, T. Pepersack, C. Gillet, R. Karmali, J. Corvilain. Calcium and vitamin D metabolism in granulomatous diseases. Clinical Rheumatology. March 1992, Volume 11, Issue 1, pp 28–36.
  3. Hypercalcaemia secondary to granulomatous disorders- a series. Malik Humayun & Tristan Richardson. Endocrine Abstracts (2012) 28 P18.
Get Medical Pearls directly to your inbox every week!
Weekly posts with high yield medical knowledge, directly to your mailbox!
Dr. C Humphreys

Internal Medicine

Recent Posts

What is Peribronchovascular Distribution on CT imaging?

A common finding described on computed tomography (CT) imaging. A disease with a peribronchovascular distribution…

2 months ago

Trapped Lung vs. Lung Entrapment

Though often used synonymously; Trapped Lung and Lung Entrapment technically describe separate entities along the…

8 months ago

Cause of Pericardial Effusion in Pulmonary Hypertension: Pathogenesis

It is not clearly understood why patients with pulmonary hypertension (PH) develop pericardial effusions. However,…

9 months ago

Difference between Mycophenolate Mofetil vs. Mycophenolate Sodium

The two drugs are not interchangeable nor dose equivalents. Mycophenolate mofetil (Cellcept) is a semi…

10 months ago

What is an “Anephric” Creatinine Rise?

Serum Creatinine can be a deceptive surrogate during an acute kidney injury. It may lag…

2 years ago

Macrophage activation syndrome vs. Hemophagocytic lymphohistiocytosis

Macrophage activation syndrome (MAS) is a life-threatening complication of rheumatic diseases (i.e SLE, Juvenile idiopathic…

2 years ago

This website uses cookies.