RESUMO
We report sarcoidosis-related hypercalcemia in a patient undergoing hemodialysis, The patient, a 54-year-old woman, had been undergoing maintenance hemodialysis since 1989. The cause of end-stage renal disease was membranoproliferative glomerulonephritis. The patient was admitted to our hospital in January 2002 for the treatment of hypercalcemia(13.5 mg/dl), which was diagnosed in December 2001. Chest X-ray showed bilateral hilar lymphadenopathy, chest CT scan showed mediastinal lymph node swelling, and Ga-scintigraphy showed abnormal accumulation of gallium in the mediastinum. The patient's intact-PTH was 80-100 pg/ml. ACE(31.4 IU/l) and 1.25(OH)2D3(85 pg/ml) were elevated, and the bronchial lavage fluid CD4/CD8 ratio was slightly elevated. Epitheloid granulomatous tissue was obtained from a subclavian lymph node biopsy. Thus, the patient was diagnosed with sarcoidosis. The hypercalcemia and bilateral hilar lymphadenopathy improved with corticosteroid therapy.
Assuntos
Hipercalcemia/diagnóstico , Diálise Renal , Sarcoidose/diagnóstico , Biomarcadores/sangue , Calcitriol/sangue , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Hipercalcemia/etiologia , Pessoa de Meia-Idade , Peptidil Dipeptidase A/sangue , Sarcoidose/complicaçõesRESUMO
Dietary soy protein isolate (SPI) and its undigested high molecular fraction (HMF) exhaustively digested with proteases, compared with casein (CAS), significantly reduced serum and liver cholesterol concentration in rats. Biliary excretion of cholesterol was significantly higher in rats fed SPI and HMF than in those fed CAS. Hepatic expression of ATP-binding cassette transporter G5 (ABCG5) and ATP-binding cassette transporter G8 (ABCG8) mRNA was significantly higher in rats fed SPI and HMF than in those fed CAS. These observations suggest that increased biliary excretion of cholesterol in SPI and HMF groups is caused by the enhanced expression of Abcg5/Abcg8.