piter
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treatment, please.
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| dxtxpx
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steroids (prednisone) and cytotoxics (methotrexate)
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| piter
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thanx
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| intern_doc
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Furosemide
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| piter
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why furusemide? just for hypercalcinosis?
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| intern_doc
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ok....
What is one thing that stand out from patient with Sarcoidosis ? hyPERcalcemia ....correct ?...and how do you RX that ? Furosemide.
You will run into that question someday. I forgot where the question come from. Either Qbank
, Qbook or one of the book
Back to the question....I guess the answer will depend on the patient symtoms. If the question stem mention HYPERCALCEMIA...then you will Rx it with furosemide...but if ONLY present with lungs problems...then steroids
Hope this clarify up...and not confuse further
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| piter
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thanx, i agree.
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| mjl1717
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Does anyone remember the cause of that hypercalcemia?
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| intern_doc
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"mjl1717" wrote:
Does anyone remember the cause of that hypercalcemia? HYPERCALCEMIA and HYPERCALCIURIA is due to complication of Sarcoidosis as result of increased syn of 1,25 dihydroxycholecalciferol
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| hiwa
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as far as I remember it is due to increased sensitivity to vit D , but iam not sure
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| hiwa
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sorry u right intern_doc it is due to synth of vit D
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| hiwa
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sorry u right intern_doc it is due to increase synth of vit D, there is also increase ACE level in active cases
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| piter
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oh, about ACE -today my friend (doctor) said, that they use ACEI in the cases of sarcoidosis, but coudn't explane why. Any comments...
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| drkjigs
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Just reading the forum... think the answer is.. sarcoidosis is a chr grannulomatous disorder with increased no. of macrophages. Besides the kidneys, small amount of calcitriol is also formed by the macrophage. Thus increased macrophages(epitheliod cells) leads to increased activated Vit D..leads to increase serum calcium. Schaumann bodies are laminated calcifications in the grannulomas becoz of increased calcium.
In Sarcoidosis, there is increased ACE & thus the use of ACE inhibitors.
hope this helps.
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| DreamingInsomniac
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WAS JUST READING THE FORUM AND THOUGHT WILL PUT THIS:::::
BUT FOR usmle ::::
SARCOIDOSIS=STEROIDS
HYPERCALCEMIA=FLUIDS; THEN THINK OF LOOP DIURETICS
(the whole process being called forced diuresis....but invariably the answer will revolve around fluids)
A Review - Vitamin D and Calcium in Sarcoidosis
Trevor G Marshall, PhD, 5 July 2003
The active hormone of Vitamin D (1,25-dihydroxyvitamin-D)(1,25-D) performs a vital function in immune diseases, including Sarcoidosis. It causes hematopoetic-stem-cells to differentiate (grow) into monocytes, the basic White Blood Cell (leukocyte), and then it causes these to differentiate (grow) into the macrophages and giant cells characteristic of sarcoid granuloma[1,2]. Without this hormone there would be no formation of granuloma. The hormone is also responsible for maintaining proper operation of the ParaThyroid, Muscle, Pancreas, Bone, Intestine, Kidneys, Heart and the Brain
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| dariush
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Speaking of Hypercalcemia, why dont we give Calcitonin or Plicamycine or even Steroids which if given in a short course decrease Ca level.
any thoughts on this ??
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| bakpity
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Quinapril amongst ACE inhibitors have found particulary useful in sarcoidosis.
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