Sarcoidosis: The Daily PANCE Blueprint

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Sarcoidosis: The Daily PANCE Blueprint

A 40-year-old African American patient presents with exertional dyspnea, dry cough, and bilateral hilar lymphadenopathy on CXR. Labs show elevated ACE levels. Macrophage activation in granulomas increases 1-alpha hydroxylase. Which laboratory abnormality is most expected?

A. Hypercalcemia
B. Hypocalcemia
C. Low CD4 count
D. High TSH
E. High uric acid

Answer and topic summary

The answer is A. Hypercalcemia

In sarcoidosis, activated macrophages convert 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D, increasing intestinal calcium absorption → hypercalcemia ± hypercalciuria.

  • Hypocalcemia – Opposite direction physiologically.
  • Low CD4 – HIV/AIDS, not sarcoidosis.
  • High TSH – Thyroid dysfunction, unrelated.
  • High uric acid – Seen in gout, tumor lysis.
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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Pulmonary ⇒ Restrictive Pulmonary Disease ⇒ Sarcoidosis

Also covered as part of the Internal Medicine PAEA EOR topic list

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