Systemic sarcoidosis presenting as asymptomatic hypercalcaemia.

A Black woman in her 70s with chronic kidney disease, HIV and type 2 diabetes was found to have persistent asymptomatic hypercalcaemia. Workup revealed non-parathyroid hormone-mediated hypercalcaemia and mediastinal lymphadenopathy. Bronchoscopy with lymph node biopsy showed non-necrotising granulomas, concerning for sarcoidosis. Her hypercalcaemia resolved with prednisone treatment. Attempts at rapid steroid taper led to recurrence of hypercalcaemia. Hypercalcaemia as the primary initial presentation of sarcoidosis, as seen in this case, is uncommon but responsive to treatment.