Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Hypercalcemia Induced by Rosai-Dorfman Disease in a Hemodialysis Patient: Histological Evidence of Extrarenal Calcitriol Overproduction
Shunsuke YamadaMai UemuraMasanori TokumotoTadashi NagaraHideko NoguchiMinako HirahashiToshiaki NakanoKazuhiko TsuruyaTakanari Kitazono
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JOURNALS OPEN ACCESS

2014 Volume 53 Issue 24 Pages 2783-2787

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Abstract

Rosai-Dorfman disease (RDD) is a rare disorder characterized by the proliferation of histiocytes in the sinus of the affected lymph nodes, which leads to massive lymphadenopathy. RDD usually presents as an increased inflammatory response and lymph node swelling. We herein report the case of a hemodialysis patient with a fever, hypercalcemia and increased serum calcitriol level who was histologically diagnosed to have RDD. Immunohistochemistry revealed an increased expression of 1α-hydroxylase by histiocytes in the dilated sinus, indicating the extrarenal overproduction of calcitriol. Treatment with oral prednisolone decreased the serum levels of inflammatory markers and calcitriol, normalized the serum calcium level and mitigated the systemic lymph node enlargement.

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© 2014 by The Japanese Society of Internal Medicine
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