A 35-year-old African American woman presents with a 3-week dry cough, fatigue, and painful red nodules on her anterior shins. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Chest radiograph reveals bilateral hilar lymphadenopathy. Serum calcium is 11.2 mg/dL (normal 8.5-10.2). She denies fever. Laboratory studies show normal parathyroid hormone levels. Which of the following best explains her hypercalcemia mechanism?
- A)Reduced calcitonin secretion from parafollicular cells
- B)Parathyroid hormone related peptide secretion by a squamous cell carcinoma
- C)Excess vitamin D intake due to malabsorption treatment
- D)Metastatic osteolysis from small cell carcinoma
- E)Increased 1 alpha hydroxylase activity in macrophages within granulomasGABARITO
Explicação
Increased 1 alpha hydroxylase activity in macrophages within granulomas is correct. Sarcoidosis is a noncaseating granulomatous disease that often presents with bilateral hilar lymphadenopathy, erythema nodosum, and hypercalcemia due to extrarenal activation o... Ver explicação completa e trilha adaptativa →