Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis-associated hypercalcemia with short-course chloroquine therapy

Article Abstract:

Sarcoidosis, which is a chronic disorder characterized by the formation of nodules of epithelial (skin) tissue in the lungs, spleen, liver, skin, mucous membranes, and the lacrimal, salivary and lymph glands, can be treated with drugs of the 4-amino quinoline class, such as chloroquine and hydroxychloroquine. Patients with sarcoidosis have high levels of calcium in their blood (hypercalcemia) because of disease-activated macrophages in the lungs, which overproduce 1,25-dihydroxyvitamin D, an active form of vitamin D. (Macrophages are immune cells that engulf and destroy foreign organisms.) 1,25-dihydroxyvitamin D facilitates the absorption of calcium by the intestines, and large amounts of 1,25-dihydroxyvitamin D can cause high concentrations of calcium in the blood serum. Chloroquine and hydroxychloroquine reduce the synthesis of 1,25-dihydroxyvitamin D and thus lower the concentration of calcium in the serum. Chloroquine inhibits macrophages from synthesizing 1,25-dihydroxyvitamin D. It has been reported to require weeks, if not months, of use for these effects to be seen. However, the reduction of 1,25-dihydroxyvitamin D and calcium was reported in a patient with sarcoidosis within 3 days of the start of treatment with chloroquine. Therefore, it is not necessary to treat patients with sarcoidosis for long periods of time with chloroquine to reduce the levels of 1,25-dihydroxyvitamin D and calcium. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Vitamin D, Chloroquine, Hypercalcemia, Calcium metabolism disorders

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Clinical course after liver transplantation in patients with sarcoidosis

Article Abstract:

Remission of sarcoidosis can be achieved after liver transplantation and treatment with cyclosporine. Cyclosporine is an immunosuppressive drug used to prevent rejection of the transplanted organ. Sarcoidosis is a progressive disease of unknown origin which can affect almost any organ in the body. Frequently, patients suffering from sarcoidosis become candidates for liver transplants because of liver failure. The records of nine patients who received liver transplants were reviewed. All nine patients had some degree of sarcoidosis of the liver. Most had other organs affected by the disease as well. All nine patients received cyclosporine. Comparison with 36 patients who received liver transplants for other reasons showed almost equivalent survival rates five years after surgery. Liver sarcoidosis was eliminated in the patients who underwent the transplants. The disease showed no evidence of progression in other organs previously affected by sarcoidosis.

Liver, Liver transplantation, Cyclosporine, Cyclosporins

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A new anti-inflammatory therapy (infliximab) for complicated sarcoidosis

Article Abstract:

An antibody against tumor necrosis factor-alpha may benefit patients with sarcoidosis who do not respond to corticosteroids. Sarcoidosis is an inflammatory disease that usually affects the lungs. Tumor necrosis factor-alpha is a pro-inflammatory substance produced by the immune system.

Health aspects, Monoclonal antibodies

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