Sun-Induced Severe Symptomatic Hypercalcemia in a Patient With Sarcoidosis: A Case Report Highlighting the Importance of Patient Education and Early Recognition

TL;DR

A sarcoidosis patient developed severe hypercalcemia after sun exposure, showing the need for patient education and timely corticosteroid treatment.

Contribution

Highlights the rare but severe risk of sun exposure in sarcoidosis patients and the critical role of corticosteroids in treatment.

Findings

Sun exposure can trigger severe hypercalcemia in sarcoidosis patients due to calcitriol overproduction.

Corticosteroids were essential for rapid improvement in this case, underscoring their importance in treatment.

Patient education on sun avoidance is crucial to prevent complications in sarcoidosis.

Abstract

Sarcoidosis is a multisystem inflammatory disorder characterized by non-caseating granulomas that can disrupt calcium metabolism through extrarenal production of calcitriol. In affected individuals, sun exposure may precipitate severe symptomatic hypercalcemia. We present the case of a 46-year-old male patient who initially presented with acute foot pain and was incidentally found to have extensive lymphadenopathy. Biopsy confirmed sarcoidosis, but the patient was lost to follow-up. One year later, after a two-week sun holiday, he developed severe hypercalcemia and acute kidney injury, presenting with fatigue, hypersomnia, and gastrointestinal symptoms. Standard treatments for hypercalcemia were ineffective, but rapid clinical improvement occurred with the initiation of corticosteroid therapy. This case highlights the importance of educating patients with sarcoidosis about the risks of sun exposure and underscores the necessity of disease-specific treatment, as corticosteroids are crucial for managing sarcoidosis-induced hypercalcemia.

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