A 48-year-old woman with newly diagnosed hypercalcemia presents with progressive dyspnea. Vital signs show BP 128/82, HR 102, RR 22, SpO2 88% on room air. Chest X-ray reveals bilateral hilar lymphadenopathy and nodular infiltrates. Serum ACE level is elevated at 68 U/L (normal <40), and 24-hour urine calcium is 450 mg/day. Serum creatinine is normal. She denies smoking history. Which of the following is the most likely diagnosis?
- A)Histoplasmosis
- B)Berylliosis
- C)SarcoidosisGABARITO
- D)Lymphocytic interstitial pneumonia
- E)Primary hyperparathyroidism
Explicação
Sarcoidosis causes hypercalcemia through extrarenal 1-α-hydroxylase production by activated macrophages. Elevated ACE and 24-hour urine calcium support the diagnosis, along with classic imaging findings of hilar adenopathy. Ver explicação completa e trilha adaptativa →