Endocrine Abstracts

Key words

GPA, granulomatosis, serum, 24 h urine, calcium.

Introduction

Granulomatosis with polyangiitis (GPA) is a very rare systemic disease of unknown etiology that is defined by the formation of granulomas in different organ systems. Due to this pathology, there may be an increase in serum and 24 h urine calcium that can have a clinical impact on the course of the disease.

Aim

The goal of this study was to assess the changes in total serum calcium and 24 h urine at the time of diagnosis in new cases of GPA from 2013 till 2018.

Materials and methods

In a retrospective study, medical records of all patients who were screened due to suspected GPA (n=48) in the Riga Eastern University Hospitals’ ’Clinic of Tuberculosis and Lung Diseases’ between the 1st of January 2013 and 31st of December 2018 were analyzed. For further analysis, only patients with first-time histologically and/or clinically confirmed diagnosis of GPA (n=30; 15 men and 15 women) were selected, and only the data from the first episode was evaluated. The information was obtained from patients’ case files and medical records in the centralized hospital information system.

Results

On average, there were 5 (ranging from 3 to 10) new GPA cases (approximately 50% women and 50% men) per year in Latvia. Patients’ age ranged from 29 to 77 years with mean age of 56 ± 13.4 years. The highest number of newly diagnosed GPA was in the age group of 50–59 years (n=12; 7 women and 5 men). Serum calcium level was evaluated only in 9 of 30 patients, hypercalcaemia was detected in one case (n=1) – 2.57 mmol/l [2.1–2.55]. 24 h urine calcium level was evaluated only in two cases (n=2), no hypercalciuria was found.

Conclusions

Most patients lack serum and/or 24 h urine calcium levels evaluated at the time of the diagnosis of GPA. Hypercalcaemia was observed in one case. Due to small number of cases and the lack of serum and urine calcium evaluation at the time of diagnosis, substantial statistical analysis was not possible. Doctors should be reminded and encouraged to perform an early basic calcium metabolism screening in GPA patients.