{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T08:20:53Z","timestamp":1772007653428,"version":"3.50.1"},"reference-count":17,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Non-parathyroid hormone (PTH)-mediated hypercalcemia has diverse etiologies, including granulomatous disorders such as sarcoidosis, in which extrarenal 1-\u03b1-hydroxylase activity leads to excess production of 1,25-dihydroxyvitamin D (1,25(OH)\u2082D). We report a rare case of sarcoidosis presenting as isolated hypercalcemia without pulmonary involvement, complicated by initially normal 1,25(OH)\u2082D levels and a false-negative core biopsy. A 44-year-old man with hypertension and type 2 diabetes presented with malaise, polyuria, and polydipsia. Laboratory evaluation showed severe hypercalcemia with suppressed PTH. PTH-related peptide, 25-hydroxyvitamin D, TSH, and albumin were normal. Imaging revealed no osseous lesions or lymphadenopathy. He improved with intravenous fluids, calcitonin, and zoledronic acid. Three months later, he re-presented with recurrent hypercalcemia and elevated 24-hour urinary calcium excretion. Outpatient evaluation revealed elevated 1,25(OH)\u2082D and retroperitoneal lymphadenopathy. Core needle biopsy was nondiagnostic, but subsequent excisional biopsies of retroperitoneal lymph node confirmed nonnecrotizing granulomatous inflammation. He was diagnosed with sarcoidosis and started on high-dose steroids, later transitioning to mycophenolate. With that treatment, calcium levels normalized quickly. This case highlights the diagnostic complexities of non-PTH-mediated hypercalcemia and underscores the importance of a comprehensive workup, including medication review, laboratory tests, radiography, and biopsy, with consideration for excisional biopsy.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag028","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:42:26Z","timestamp":1769172146000},"source":"Crossref","is-referenced-by-count":0,"title":["Isolated nonparathyroid hormone-mediated hypercalcemia: a rare presentation of retroperitoneal sarcoidosis"],"prefix":"10.1210","volume":"4","author":[{"given":"Chao","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Rochester General Hospital , New York, NY 14621 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7337-2565","authenticated-orcid":false,"given":"Ranjini","family":"Vengilote","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rochester General Hospital , New York, NY 14621 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"Aviles-Melendez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Rochester General Hospital , New York, NY 14607 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alshaima","family":"Yousef","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rochester General Hospital , New York, NY 14621 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0177-5908","authenticated-orcid":false,"given":"Michael","family":"Quartuccio","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Rochester General Hospital , New York, NY 14607 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"5","key":"2026022502391198200_luag028-B1","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1210\/er.2016-1070","article-title":"Vitamin D-mediated hypercalcemia: mechanisms, diagnosis, and treatment","volume":"37","author":"Tebben","year":"2016","journal-title":"Endocr Rev"},{"issue":"4","key":"2026022502391198200_luag028-B2","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.ecl.2021.07.008","article-title":"Pathophysiology of hypercalcemia","volume":"50","author":"Goltzman","year":"2021","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"15","key":"2026022502391198200_luag028-B3","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1056\/NEJMcp2113128","article-title":"Cancer-associated hypercalcemia","volume":"386","author":"Guise","year":"2022","journal-title":"N Engl J Med"},{"issue":"4","key":"2026022502391198200_luag028-B4","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.ecl.2021.07.002","article-title":"Endocrine disorders with Parathyroid hormone-independent hypercalcemia","volume":"50","author":"Simonsen","year":"2021","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"16","key":"2026022502391198200_luag028-B5","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2022.18331","article-title":"Hypercalcemia: a review","volume":"328","author":"Walker","year":"2022","journal-title":"JAMA"},{"key":"2026022502391198200_luag028-B6","doi-asserted-by":"crossref","first-page":"e935821","DOI":"10.12659\/MSM.935821","article-title":"A review of current clinical concepts in the pathophysiology, etiology, diagnosis, and management of hypercalcemia","volume":"28","author":"Tonon","year":"2022","journal-title":"Med Sci Monit"},{"issue":"11","key":"2026022502391198200_luag028-B7","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1056\/NEJMcp1714213","article-title":"Primary hyperparathyroidism","volume":"379","author":"Insogna","year":"2018","journal-title":"N Engl J Med"},{"issue":"11","key":"2026022502391198200_luag028-B8","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1056\/NEJMra2101555","article-title":"Challenges of sarcoidosis and its management","volume":"385","author":"Drent","year":"2021","journal-title":"N Engl J Med"},{"issue":"8","key":"2026022502391198200_luag028-B9","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1164\/rccm.202002-0251ST","article-title":"Diagnosis and detection of sarcoidosis. 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