Abstract
Introduction: The coexistence of primary hyperparathyroidism (PHPT) and sarcoidosis is rare and presents a diagnostic challenge, as both disorders can independently cause hypercalcemia.
Case report: We report the case of a 49-year-old woman with ocular and pulmonary sarcoidosis who developed progressive asthenia and persistent hypercalcemia despite corticosteroid therapy. Serum calcium was 2.8 mmol/L, with elevated parathyroid hormone (PTH) at 296 pg/mL. Cervical ultrasonography and 99mTc-sestamibi SPECT/CT localized a left inferior parathyroid adenoma. Surgical excision normalized serum calcium levels with sustained biochemical remission at 2-year follow-up.
Conclusion: Persistent hypercalcemia despite corticosteroid therapy in a patient with sarcoidosis should prompt investigation for concomitant PHPT to guide appropriate treatment.
Keywords: Sarcoidosis, Primary hyperparathyroidism, Hypercalcemia, Parathyroid neoplasms, Vitamin D
