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논문분류	춘계학술대회 초록집
제목	Peritoneal Sarcoidosis With Hypercalcemia-Induced AKI
저자	Heejeong Kim
출판정보	2025; 2025(1):
키워드	Peritoneal sarcoidosis, Hypercalcemia, AKI
초록	Sarcoidosis is a granulomatous disease that involves the entire body. It is accompanied by hypercalcemia in approximately 2-63% of cases and can cause AKI in severe cases. Hypercalcemia in sarcoidosis requires careful evaluation as it can mimic other conditions like malignancies or primary hyperparathyroidism. We describe a rare case of peritoneal sarcoidosis with hypercalcemia-induced AKI in an elderly male patient. A 79-year-old man with underlying hypertension, ischemic heart disease, and CKD4(baseline Cr 2.09mg/dl/eGFR 28mL/min/1.73m2) presents with AKI with hypercalcemia (Bun/Cr 74.9mg/dl /6.63mg/dl, Ca 12.9mg/dl, ionized Ca 1.57mmol/L). He was admitted for hypercalcemia evaluation after further laboratory tests confirmed low PTH (11.83pg/ml), high ACE/CA19-9 (74U/L / 82.11U/mL) We performed abdominal/thoracic CT, which showed a diffuse fat stranding infiltration within the greater omentum and peritoneal thickening with small ascites, suspicious for primary peritoneal mesothelioma.(Fig.1-A) Due to above findings, an additional PET-CT scan was performed, which showed diffuse FDG uptake in the peritoneum and omentum.(Fig.1-B) We performed a US-guided peritoneal needle biopsy to differentiate malignancy. Peritoneal biopsy confirmed non-necrotizing granulomatous inflammation. (Fig.2) After multidisciplinary consultation, we diagnosed peritoneal sarcoidosis and initiated systemic steroid therapy (prednisolone 30mg) to control hypercalcemia-induced AKI and ascites. Dramatic improvement in hypercalcemia and creatinine levels was noted after steroid therapy. After 2 months, creatinine (2.55mg/dl) and calcium/ACE (7.6mg/dl/55U/L) levels returned to previous and normal levels, respectively. Follow-up PET-CT showed decreased overall uptake along the peritoneum and omentum. Hypercalcemia is a notable complication of sarcoidosis. Hypercalcemia requires careful evaluation as it needs to be differentiated from other conditions such as malignancy or primary hyperparathyroidism. Early diagnosis and appropriate treatment are crucial for preventing complications.
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