Chest
Selected ReportsPregnancy and Sarcoidosis: An Insight Into the Pathogenesis of Hypercalciuria
Section snippets
Case Report
This 33-year-old woman received a diagnosis of sarcoidosis 5 months after her first delivery. The diagnosis was based on a skin lesion biopsy and bilateral parenchymal lesions on chest radiograph. Except for the skin lesions, she had no other symptoms. Her mother also had sarcoidosis, which was detected after her second pregnancy, and remitted after a course of corticosteroids without further relapse. The present patient was referred to our service, because of severe hypercalciuria (24-h urine
Materials and Methods
The ADVIA 1650 analyzer (Bayer Diagnostics; Bershire, UK) was used to estimate serum creatinine, calcium, albumin, urine creatinine, and urine calcium levels. The Jaffe reaction and enzymatic reaction of Tanganelli was used to measure urine creatinine and serum creatinine respectively. The Doumas, Watson, and Biggs method using bromcresol green as the binding dye was used to estimate serum albumin. The reaction between calcium and o-cresolphthalein complex one was used to measure serum and
Results
Hypercalciuria that had subsided 1 year after the patient's first delivery returned early in the second pregnancy. In contrast to her first pregnancy, it persisted even after delivery to her latest follow-up in October 2003, but at lower levels than those seen during pregnancy (Table 2). The 1,25-dihydroxy vitamin D (calcitriol) level that was normal before pregnancy increased throughout pregnancy, and became normal soon after delivery only to rise again and remain high thereafter.
Discussion
Sarcoidosis complicating pregnancy was first reported by Nordland et al12 in 1946. Their patient, who had idiopathic thrombocytopenic purpura and sarcoidosis of the spleen, underwent splenectomy and subsequently had a normal delivery. Mayock et al6 studied 16 pregnancies in 10 patients with sarcoidosis and found that lymphadenopathy, parenchymal lung lesions, and hyperglobulinemia improved during pregnancy and returned after delivery, while chronic uveitis did not improve. Djrolo et al7
Conclusion
Pregnancy complicating sarcoidosis is a well-documented entity. Physiologic changes in mineral metabolism during pregnancy can complicate sarcoidosis-related calcium disturbances. An increased level of calcitriol is central to the calcium abnormalities in sarcoidosis, which lead to hypercalciuria and undetectable levels of PTH, throughout pregnancy, in the presence of normal serum calcium. This report also highlights the familial occurrence of sarcoidosis.
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Dermatologic conditions in patients of color who are pregnant
2017, International Journal of Women's DermatologyCitation Excerpt :There is also a higher risk of cesarean deliveries and postpartum hemorrhages (Hadid et al. 2015). In women who are pregnant and have advanced pulmonary disease or extrapulmonary lesions, exacerbation of the disease can manifest with hypercalcemia as well as respiratory and/or heart failure that is secondary to restrictive disease (Ellafi and Valeyre 1999; Subramanian et al. 2004). Scleroderma also has increased incidence and severity in women of black race compared with Caucasian patients (Steen et al. 1997).
Childbirths and risk of female predominant and other autoimmune diseases in a population-based Danish cohort
2012, Journal of AutoimmunityCitation Excerpt :If factors operating during pregnancy or the postpartum period somehow trigger clinical symptoms in otherwise asymptomatic sarcoidosis patients, this might provide a theoretical explanation for our findings. In support for this view, a previous study suggested that sarcoidosis might be complicated during pregnancy through altered calcium metabolism [31]. We also found a positive association between the number of children and a woman’s risk of erythema nodosum.
Association of the 3050G>C Polymorphism in the Cyclooxygenase 2 Gene with Systemic Sarcoidosis
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