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Hypercalcaemic encephalopathy as a presenting manifestation of sarcoidosis
  1. Adrija Ray1,
  2. Animesh Kar2,
  3. Biman Kanti Ray3 and
  4. Souvik Dubey4
  1. 1R G Kar Medical College and Hospital, Kolkata, West Bengal, India
  2. 2R N Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
  3. 3Neuromedicine, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
  4. 4Neuromedicine, Institute of Postgraduate Medical Education and Research Bangur Institute of Neurology, Kolkata, West Bengal, India
  1. Correspondence to Dr Souvik Dubey; drsouvik79{at}


A 66-year-old woman presented to us with features of encephalopathy with asterixis, preceded by unsteadiness of gait and behavioural abnormalities. On subsequent investigations, hypercalcaemic crisis and compromised renal function were noted. Stepwise approach to determine the cause behind hypercalcaemia with compromised renal function revealed underlying granulomatous disease (sarcoidosis). Later, development of maculopapular rash and subsequent biopsy from the lesion confirmed the diagnosis of sarcoidosis. Her clinical and biochemical parameters improved considerably on initiation of conservative pharmacological therapy.

  • neurology
  • endocrinology

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  • Contributors AR: planning, conception, reporting, interpretation of data and manuscript preparation. AK: conduct patient management and acquisition and analysis of data. BKR: planning and interpretation of data. SD: conception, design and manuscript writing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.