Hypercalcaemia due to sarcoidosis corrects with bisphosphonate treatment.

We report a case of sarcoid hypercalcaemia treated with the bisphosphonate, APD [(3-amino-1-hydroxypropylidene)-1,1-bisphosphonate]. Investigations showed that the hypercalcaemia was associated with a high plasma 1,25 dihydroxy vitamin D concentration. A low dietary intake of calcium partially corrected the hypercalcaemia but APD rapidly normalized plasma calcium without reducing the elevated 1,25 dihydroxy vitamin D concentration. The case demonstrates that hypercalcaemia in sarcoidosis results from the effects of 1,25 dihydroxy vitamin D on bone as well as on calcium absorption and that prolonged suppression of the effect on bone occurs with APD treatment.