A Case of Sjogren’s Syndrome Associated with Sarcoidosis and Hypercalcemia Related to Secondary Hyperparathyroidism

Abstract

A 65-year-old woman suffering from primary Sjogren’s syndrome was admitted to our department of internal medicine for uncontrolled diabetes. Investigations revealed clinical and biological cholestasis with steatotic hepatomegaly and granulomatous hepatitis with eosinophilic necrosis and cholestatic lesions. Taking into consideration, the diagnosis of sarcoidosis, special investigations were performed revealing a hypercalcemia, labial granulomatous lesions of minor salivary glands, a pulmonary restrictive syndrome and bilateral micronodules and lymph nodes of Barety's space. The diagnosis of sarcoidosis was then made and a prednisone therapy started. The course was favorable except for the persistence of hypercalcemia. Hyperparathyroidism with severe vitamin D deficiency were diagnosed.