What symptom is typically associated with granulomatous disease like sarcoidosis?

Granulomatous diseases, such as sarcoidosis, are characterized by the formation of granulomas, which are clusters of immune cells that can disrupt normal bodily functions. One of the most notable biochemical abnormalities seen in sarcoidosis is hypercalcemia. This condition occurs due to increased production of active vitamin D (calcitriol) from macrophages in the granulomas, leading to enhanced intestinal absorption of calcium and increased mobilization of calcium from the bones.

As a result, patients with sarcoidosis may present with elevated serum calcium levels, often without the associated effects of primary hyperparathyroidism. This hypercalcemia can manifest clinically with various nonspecific symptoms like fatigue, weakness, and kidney stones, and severe cases can even cause complications related to increased calcium levels.

Understanding this relationship is critical for recognizing and managing the potential complications associated with granulomatous diseases such as sarcoidosis.