Reversible cerebellar signs due to sarcoid-related severe hypercalcaemia

摘要

A 58-year-old Caucasian man presented on the acute medical take with a week-long history , of impaired cognition, abnormal gait and constitutional symptoms (weight loss and anorexia). Past medical history was significant for insulin controlled type 2 diabetes mellitus. There were no relevant occupational or travel factors.Examination findings were significant for centripetal adiposity (weight: 149 kg, body mass index: 48), horizontal nystagmus, dysdiadochokinesis and an ataxic broad-based gait. Other general and neurological examination was normal.Significant blood tests revealed severe hypercal-caemia (corrected calcium of 4.4mmol/l) and renal impairment (creatinine 190mmol/l, baseline 100mmol/l 2 months earlier). Parathyroid hormone was suppressed (0.3 ng/l), and full blood count was normal (eosinophil count of <0.04). Serum electro-phoresis showed no monoclonal bands.