{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:36:40Z","timestamp":1767688600511,"version":"3.48.0"},"reference-count":30,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The diagnosis of parathyroid hormone (PTH)-independent hypercalcemia can be challenging due to its heterogeneous etiology. We report a case of a 65-year-old woman diagnosed with PTH-independent hypercalcemia 7 years prior. In view of elevated serum angiotensin-converting enzyme (ACE) and 1,25-dihydroxyvitamin D, a granulomatous etiology was suspected. The 18F-fluorodeoxyglucose (FDG) positron emission tomography\u2013computed tomography (PET-CT) revealed diffuse uptake in the axial and appendicular muscles, suggestive of sarcoidosis of muscle. She responded to a 6-week course of glucocorticoids, with normalization of calcium levels that was sustained for 7 years until her recent presentation with weight loss and anorexia. The current laboratory parameters mimicked the pattern of the last episode, and the 18F-FDG PET-CT also showed a similar isotope uptake in axial and appendicular muscles, most prominently in the paraspinal, gluteal, and thigh muscles. No additional FDG-avid lesion was detected on the PET-CT scan. An ultrasound-guided muscle biopsy from the right mid-paraspinal muscle demonstrated a lymphoplasmacytic infiltrate with epithelioid cell granuloma and Langhans giant cells, consistent with sarcoidosis. The hypercalcemia responded promptly to glucocorticoid therapy, which was tapered over 2 months. A final diagnosis of PTH-independent recurrent hypercalcemia due to isolated muscle sarcoidosis was reached, representing an unusually rare manifestation of sarcoidosis.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf271","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T14:02:09Z","timestamp":1763560929000},"source":"Crossref","is-referenced-by-count":0,"title":["An Unusual Etiology of Recurrent Parathyroid Hormone\u2013Independent Hypercalcemia"],"prefix":"10.1210","volume":"3","author":[{"given":"Simran","family":"Thakkar","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Indraprastha Apollo Hospitals , New Delhi 110076 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8458-9371","authenticated-orcid":false,"given":"Saptarshi","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Indraprastha Apollo Hospitals , New Delhi 110076 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parul","family":"Sobti","sequence":"additional","affiliation":[{"name":"Department of Pathology, Indraprastha Apollo Hospitals , New Delhi 110076 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meenakshi","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Pathology, Indraprastha Apollo Hospitals , New Delhi 110076 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balraj Singh","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Radiology, Indraprastha Apollo Hospitals , New Delhi 110076 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambrish","family":"Mithal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Max Superspecialty Hospital , New Delhi 110017 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"issue":"2","key":"2026010603315676700_luaf271-B1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.11138\/ccmbm\/2017.14.1.131","article-title":"The changing profile of hypercalcemia in a tertiary care setting in North India: an 18-month retrospective study","volume":"14","author":"Kuchay","year":"2017","journal-title":"Clin Cases Miner Bone Metab"},{"issue":"5","key":"2026010603315676700_luaf271-B2","doi-asserted-by":"crossref","first-page":"453","DOI":"10.4103\/ijem.ijem_223_21","article-title":"Prevalence and etiological profile of hypercalcemia in hospitalized adult patients and association with mortality","volume":"26","author":"Sulaiman","year":"2022","journal-title":"Indian J Endocrinol Metab"},{"issue":"4","key":"2026010603315676700_luaf271-B3","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1093\/ndt\/gfy054","article-title":"Hypercalcemia: etiology and management","volume":"33","author":"Renaghan","year":"2018","journal-title":"Nephrol Dial Transplant"},{"issue":"1","key":"2026010603315676700_luaf271-B4","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/lungindia.lungindia_960_20","article-title":"Clinical profile of 327 patients with sarcoidosis in India: an ambispective cohort study in a tuberculosis (TB) endemic population","volume":"39","author":"Madan","year":"2022","journal-title":"Lung India"},{"key":"2026010603315676700_luaf271-B5","doi-asserted-by":"crossref","first-page":"105998","DOI":"10.1016\/j.rmed.2020.105998","article-title":"Clinical features and outcomes of asymptomatic pulmonary sarcoidosis. 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