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Thus our findings of an absence of benefit from vitamin D supplements together with infrequent but significant hypercalcaemia suggest that there is little indication for vitamin D supplements in patients

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Hypercalcaemia requires systemic treatment and sarcoidosis patients are often advised to decrease Vitamin D uptake On the other hand Vitamin D is recently shown to possess serious immune

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Increased extrarenal 1 25 dihydroxyvitamin D synthesis can lead to hypercalcemia and its complications However 25 hydroxyvitamin D deficiency and insufficiency are virtually universal

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Presently there are no clear guidelines regarding vitamin D supplementation as a part of osteoporosis prevention in patients with vitamin D de ciency and sarcoidosis

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Although patients with sarcoidosis are typically deficient in 25 hydroxyvita min D 5 repletion of vitamin D is controversial in light of the hypercalcemia risk

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In sarcoidosis serum levels of 25 OH D might be normal or decreased However due to the granulomatous process there can be an increase in the conversion of 25 OH D to its active

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In sarcoidosis there is often increased metabolism of 25 OH vit D to 1 25 dihydroxy vitamin D 1 25 OH vit D so 25 OH vit D may remain low despite high levels of 1 25 OH vit D In

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When managing vitamin D deficiency in sarcoidosis patients it is essential to take a cautious approach to avoid exacerbating hypercalcemia The European Respiratory Journal

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After the initial description of extrarenal synthesis of 1 25 dihydroxyvitamin D 1 25 OH 2D three decades ago extensive progress has been made in unraveling the