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Tuesday, March 11, 2014
Does Sarcoidosis Cause Osteoperosis?
I am a 50 year old white woman with an h/o sarcoidosis which presented 16 years ago as Loeffler’s Syndrome and was treated with high dose aspirin without recurrence. My mother had the same presentation and no subsequent recurrence.
This year I had a baseline bone density, less than 1 year after onset of menopause, which showed osteoporosis of spine and osteopenia of hip and femur. I do not drink alcohol, do not smoke, have no history of steroid use, and no family history of osteoporosis.
Workup for secondary causes showed normal thyroid, parathyroid, SPEP. 25OH vitamin D was 31 and 1, 25 vitamin D was in upper limit of normal range. The 24 hour urine collection had over 500mg Calcium. I am currently taking about calcium 1500mg and vitamin D 800-1000 IU. Is osteoporosis a common consequence of sarcoidosis in the absence of steroid treatment? If so, how is it best treated?
Dear Madam- This is an excellent question! In other words, there is not much known about the relationship between sarcoidosis and bone density in untreated patients.
However, a study of 51 untreated patients published in 2007 showed normal bone density. In your case, the data suggests that you may be losing calcium in your urine as opposed to not absorbing enough due to low vitamin D levels or diet.
This loss of calcium in the urine may be unrelated to sarcoidosis. Some people lose calcium in their urine due to a problem with the kidneys. This is usually not a serious condition. I would suggest that you talk to your doctors about further testing and possible treatments to reduce the loss of calcium.
Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University