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Enhanced Production Rate of 1,25-Dihydroxyvitamin D in Sarcoidosis^*

KARL L. INSOGNA, BARBARA E. DREYER, MARYANN MITNICK, ALICE F. ELLISON and ARTHUR E. BROADUS

West Haven Veterans Administration Medical Center West Haven, Connecticut 06516
The Department of Medicine, Yale University School of Medicine New Haven, Connecticut 06510

Address all correspondence and requests for reprints to: Karl L. Insogna, M.D., Research/151, West Haven Veterans Administration Medical Center, West Spring Street, West Haven, Connecticut 06516.

We determined the metabolic clearance and production rates of 1,25-dihydroxyvitamin D [1,25-(OH)₂D] in 5 patients with sarcoidosis who had either hypercalciuria or hypercalcemia to examine whether abnormalities in the metabolism of this hormone existed. The mean MCR in the 5 patients with sarcoidosis [40 ± 9 (±SD) mL/min] was similar to that in 13 normal subjects (37 ± 6 mL/min) and that in 9 patients with absorptive hypercalciuria and renal stones (35 ± 4 mL/min). However, the mean serum 1,25-(OH)₂D concentration was significantly higher in the patients with sarcoidosis (211 ± 60 pmol/L) than in either of the other 2 groups. The mean 1,25-(OH)₂D production rate was markedly elevated in the patients with sarcoidosis (12.4 ± 5.3 /unol/day), being more than 2-fold greater than the normal mean value (5.4 ± 1.2 jimol/day). The highest production rates were found in patients with hypercalcemia, whereas subjects with hypercalciuria had production rates comparable to those in the patients with absorptive hypercalciuria. These data indicate that there is no impairment in the clearance of 1,25-(OH)₂D in patients with sarcoidosis and that the elevated serum 1,25-(OH)₂D levels are due to an increase in its production rate

^* This work was supported by a grant from the V.A., Grant RR-125 from the General Clinical Research Center Branch of the NIH, and NIH Grant AM-31998.

Recipient of a Clinical Associate Physician Award from the GCRC Branch, NIH.

Received April 27, 1987.

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