{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:29:36Z","timestamp":1787761776073,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>\n                    Sarcoidosis is a chronic granulomatous disease affecting various organs and is one of the causes of parathyroid hormone (PTH)-independent hypercalcemia. However, sarcoidosis\n                    <jats:italic toggle=\"yes\">per se<\/jats:italic>\n                    presenting with severe hypercalcemia is very rare. We present a case with an initial presentation of hypercalcemic crisis (corrected calcium of 16.8 mg\/dl) and suppressed iPTH (7.2 pg\/ml). Upon thorough evaluation, including biochemical, radiology, and histopathology, of the right inguinal lymph node biopsy, extrapulmonary sarcoidosis was diagnosed. The patient was initiated on glucocorticoid therapy, leading to clinical and biochemical improvement. This case is characterized by hypophosphatemia and inappropriately normal 1,25-dihydroxy vitamin D level, a finding rarely reported in the literature. Hypercalcemia may be due to the overproduction of bone-resorbing cytokines, INF-\u03b1, IL-6, IL-1\u03b2, and PTHrP.\n                  <\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_203_25","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T06:01:01Z","timestamp":1752904861000},"page":"3028-3031","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A curious case of hypercalcemic crisis in sarcoidosis: The missing link beyond 1,25(OH)2D"],"prefix":"10.4103","volume":"14","author":[{"given":"Ajaz","family":"Qadir","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raiz A.","family":"Misgar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javid A.","family":"Sofi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"R1-20250804","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1513\/AnnalsATS.201511-760OC","article-title":"Sarcoidosis in America. Analysis based on health care use","volume":"13","author":"Baughman","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"R2-20250804","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00408-016-9952-6","article-title":"Influence of gender on epidemiology and clinical manifestations of sarcoidosis: A population-based retrospective cohort study 1976-2013","volume":"195","author":"Ungprasert","year":"2017","journal-title":"Lung"},{"key":"R3-20250804","doi-asserted-by":"crossref","first-page":"6686","DOI":"10.1111\/joim.13629","article-title":"Sarcoidosis: Epidemiology and clinical insights","volume":"293","author":"Rossides","year":"2023","journal-title":"J Intern Med"},{"key":"R4-20250804","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/pgmj.63.743.745","article-title":"The incidence and causes of hypercalcemia","volume":"63","author":"Dent","year":"1987","journal-title":"Postgrad Med J"},{"key":"R5-20250804","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":"R6-20250804","first-page":"e56271","article-title":"Calcium chaos in sarcoidosis: A tale of severe hypercalcemia's diagnostic challenge","volume":"16","author":"Satasia","year":"2024","journal-title":"Cureus"},{"key":"R7-20250804","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1164\/rccm.202002-0251ST","article-title":"Diagnosis and detection of sarcoidosis. An Official American Thoracic Society clinical practice guideline","volume":"201","author":"Rouser","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"R8-20250804","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00330-015-4169-2","article-title":"Hepatic sarcoidosis in patients presenting with liver dysfunction: Imaging appearance, pathological correlation and disease evolution","volume":"26","author":"Fetzer","year":"2016","journal-title":"Eur Radiol"},{"key":"R9-20250804","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1038\/ajg.2017.231","article-title":"Clinical characteristics and outcome of hepatic sarcoidosis: A population based study 1976\u20132013","volume":"112","author":"Ungprasert","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"R10-20250804","article-title":"Sarcoidosis- related hypercalcaemia due to production of parathyroid hormone-related peptide","author":"Van Raalte","year":"2015","journal-title":"BMJ Case Rep 2015"},{"key":"R11-20250804","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.4158\/EP11060.CR","article-title":"Parathyroid hormone-related protein: An unusual mechanism for hypercalcemia in sarcoidosis","volume":"17","author":"Krikorian","year":"2011","journal-title":"Endocr Pract"},{"key":"R12-20250804","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1210\/jcem-60-5-960","article-title":"Isolation and structural identification of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis","volume":"60","author":"Adams","year":"1985","journal-title":"J Clin Endocrinol Metab"},{"key":"R13-20250804","doi-asserted-by":"crossref","first-page":"545413","DOI":"10.3389\/fimmu.2020.545413","article-title":"Treatment of sarcoidosis: A multidisciplinary approach","volume":"11","author":"Gerke","year":"2020","journal-title":"Front Immunol"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_203_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:07:46Z","timestamp":1787760466000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_203_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_203_25","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-02-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}