Calcium and Vitamin D in Saroidosis? - USMLE Forums
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  #1  
Old 08-27-2012
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Question Calcium and Vitamin D in Saroidosis?

A new 28 year younger black woman mother of 2 kids, comes to you for a consultation about a cough and weakness of the muscles on one side of the face. She is a non-smoker, no illicit drugs used, no recent travel, and was joying a good health before the appearance of those symptoms. After all data was concluded, you decided to do a thorax x-ray & serum test, in the x-ray you suspected a bilateral hilar lymphadenopathy, and the serum analysis an elevated levels of ACE. Which of the following is most like the true about the diagnosis?

A) Decrease in bone resorption and increase intestinal absorption of Ca++ and PhO4
B) Increase Vitamin D2 with the conversion of epithelioid macrophage
C) Increase Vitamin 25-HO D3 with the conversion of epithelioid macrophage
D) Increase Vitamin 1,25(HO) D3 with the conversion of epithelioid macrophage
E) Increase Vitamin D3 with the conversion of epithelioid macrophage
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Old 08-27-2012
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in sarcoidosis....hypercalcemia is due to increased 1 alpha hydroxylase in macrophages....
1 alpha hydroxylase helps in converting 25 hydroxy vit.D to 1,25 hydroxy vitD
so, my answer is D) increase 1,25 vit .D
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Old 08-27-2012
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Default my answer

D) Increase Vitamin 1,25(HO) D3 with the conversion of epithelioid macrophage

I'm not sure if I understand that answer though...
macrophages in the granulomas convert vit. D into it's active form. Please correct me if I am wrong
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Old 08-27-2012
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Quote:
Originally Posted by Casandra View Post
D) Increase Vitamin 1,25(HO) D3 with the conversion of epithelioid macrophage

I'm not sure if I understand that answer though...
macrophages in the granulomas convert vit. D into it's active form. Please correct me if I am wrong
yes and vit D active form is 1,25-(OH)2 D3 so what u don't understand?
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Old 08-27-2012
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Originally Posted by debs View Post
yes and vit D active form is 1,25-(OH)2 D3 so what u don't understand?
I wasn't sure about the wording of the answer - this part "with the conversion of epithelioid macrophage"
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Old 08-27-2012
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Quote:
Originally Posted by Casandra View Post
I wasn't sure about the wording of the answer - this part "with the conversion of epithelioid macrophage"
yeah i agree with u...for me too
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I wasn't sure about the wording of the answer - this part "with the conversion of epithelioid macrophage"

ok now I get it... So I search epithelioid macrophage and it pop up. " A granuloma can be defined as "an organized collection of epithelioid macrophages" "Epithelioid histiocytes (Epithelioid cells) are activated macrophages resembling epithelial cells"--- Source Wiki

But don't let some buzzword fool u if u know the correct answer and there is no other extremely similar answer. hope it help but it is just venky2600 says "hypercalcemia due to elevated 1alfa-hydroxylase-mediated vitamin D activation in epithelioid macrophages" --Quote first aid 2011 page 386
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Quote:
Originally Posted by debs View Post
ok now I get it... So I search epithelioid macrophage and it pop up. " A granuloma can be defined as "an organized collection of epithelioid macrophages" "Epithelioid histiocytes (Epithelioid cells) are activated macrophages resembling epithelial cells"--- Source Wiki

But don't let some buzzword fool u if u know the correct answer and there is no other extremely similar answer. hope it help but it is just venky2600 says "hypercalcemia due to elevated 1alfa-hydroxylase-mediated vitamin D activation in epithelioid macrophages" --Quote first aid 2011 page 386
yes, goljan too says it is due to 1 alpha hydroxylase increase......
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Old 08-27-2012
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D all non caseating granulomas cause hypercalcemia due to alpha 1 hydroxylase activity.
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