Effective Reduction in the Serum 1,25-Dihydroxyvitamin D and Calcium Concentration in Sarcoidosis-Associated Hypercalcemia with Short-Course Chloroquine Therapy

Brief Reports1 September 1989Effective Reduction in the Serum 1,25-Dihydroxyvitamin D and Calcium Concentration in Sarcoidosis-Associated Hypercalcemia with Short-Course Chloroquine TherapyJohn S. Adams, MD, Marie M. Diz, BS, Om P. Sharma, MDJohn S. Adams, MD, Marie M. Diz, BS, Om P. Sharma, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-5-437 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe chronic administration of drugs of the 4-amino quinoline class, including quinacrine, chloroquine, and hydroxychloroquine, has been used for many years to effectively manage many of the cutaneous (1) and extracutaneous symptoms (2) of sarcoidosis. More recently chloroquine (3) and hydroxychloroquine (4) were shown to reduce the extrarenal synthesis of 1,25-dihydroxyvitamin D (l,25-(OH)2-D) and to lower the serum calcium concentration and fractional urinary calcium excretion rate in hypercalcemic-hypercalciuric patients with sarcoidosis. These reports (3, 4) claim that the 1,25-(OH)2-D and calcium lowering effect of these drugs requires weeks, if not months, of therapy. However, measurements of the serum...References1. ShafferCahnLevy BME. Sarcoidosis apparently cured by quinocrine (Atabrine) hydrochloride. Arch Dermatol. 1953;67: 640-2. Google Scholar2. MorseCohnHirschSchaedler SZJR. The treatment of sarcoidosis with chloroquine. Am J Med. 1961;30:779-82. CrossrefMedlineGoogle Scholar3. O'LearyJonesYipLohnesCohanimYendt TGADME. The effects of chloroquine on serum 1,25-dihydroxyvitamin D andcalcium metabolism in sarcoidosis. N Engl J Med. 1986;315:727-30. CrossrefMedlineGoogle Scholar4. BarréGascon-BarréMeakinsGoltzman PMJD. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis. Am J Med. 1987;82:1259-62. CrossrefMedlineGoogle Scholar5. InsognaDreyerMitnichEllisonBroadus KBMAA. Enhanced production rate of 1,25-dihydroxyvitamin D in sarcoidosis. J Clin Endocrinol Metab. 1988;66:72-5. CrossrefMedlineGoogle Scholar6. AdamsSingerGacad JFM. Isolation and structural identification of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis. J Clin Endocrinol Metab. 1985;60:960-6. CrossrefMedlineGoogle Scholar7. AdamsGacad JM. Characterization of 1 alpha-hydroxylation of vitamin D3 sterols by cultured alveolar macrophages from patients with sarcoidosis. J Exp Med. 1985;161:755-65. CrossrefMedlineGoogle Scholar8. KrogstadSchlesinger DP. Acid-vesicle function, intracellular pathogens, and the action of chloroquine against Plasmodium falciparum. N Engl J Med. 1987;317:542-9. CrossrefMedlineGoogle Scholar9. ChangMusserMcGregor JJH. Phospholipase A2: function and pharmacological regulation. Biochem Pharmacol. 1987;36:2429-36. CrossrefMedlineGoogle Scholar10. SandlerWinearlsFraherClemensSmithO'Riordan LCLTRJ. Studies of the hypercalcaemia of sarcoidosis: effect of steroids and exogenous vitamin D3 on the circulating concentrations of 1, 25-dihydroxyvitamin D3. Q J Med. 1984;53:165-80. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the Orthopedic Hospital-University of Southern California and the University of Southern California School of Medicine. For current author addresses, see end of text. 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A ReminderSarkoidoseAssociated Systemic Diseases 1 September 1989Volume 111, Issue 5Page: 437-438KeywordsAttentionCalciumChloroquineDrugsEndocrinologyExcretionHydroxychloroquineHypercalcemiaOrthopedicsSarcoidosis Issue Published: 1 September 1989 PDF DownloadLoading ...