PERAN SUPLEMENTASI VITAMIN D PADA TATA LAKSANA SARKOIDOSIS KUTIS
DOI:
https://doi.org/10.33820/mdvi.v49i4.311Keywords:
granuloma, hiperkalsemia, sarkoidosis, vitamin DAbstract
Sarkoidosis merupakan kelainan inflamasi multisistem yang ditandai dengan terbentuknya granuloma dan terjadi pada berbagai organ, terutama paru dan kulit. Granuloma berisi sel imun berupa makrofag yang juga berperan dalam metabolisme vitamin D. Makrofag pada granuloma sarkoidosis terbukti mampu memproduksi 1,25-dihidroksi vitamin D (kalsitriol) di luar ginjal yang berasal dari prekusor 25-hidroksi vitamin D (calcifediol). Selain itu, metabolisme 1,25-dihidroksi vitamin D di makrofag tidak memiliki mekanisme umpan balik yang efektif dalam menjaga keseimbangan kadar vitamin D di tubuh. Penurunan ini dapat mengganggu keseimbangan kadar kalsium pada pasien sarkoidosis. Pemberian suplementasi vitamin D dianggap sebagai terapi adjuvan dalam tata laksana sarkoidosis, namun diketahui dapat menyebabkan hiperkalsemia. Perubahan kadar vitamin D pada sarkoidosis tidak selalu menjadi indikasi pemberian suplementasi vitamin D, diperlukan pemeriksaan laboratorium yang tepat sebelum memberikan suplementasi vitamin D guna mengurangi risiko terjadinya hiperkalsemia pada sarkoidosis. Pemberian suplementasi vitamin D dalam dosis rendah diperbolekan bagi pasien sarkoidosis yang tidak disertai kondisi hiperkalsemia, namun perlu dilakukan pemeriksaan kadar vitamin D dan kalsium secara rutin.
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References
1. Moor CC, Kahlmann V, Culver DA, Wijsenbeek MS. Comprehensive Care for Patients with Sarcoidosis. J Clin Med. 2020;9(2):390.
2. Burke R, Rybiciki B, Rao D. Calcium and vitamin D in sarcoidosis: How to assess and manage. Semin Respir Crit Care Med. 2010;31(4):474–84.
3. Baughman RP, Papanikolaou I. Current concepts regarding calcium metabolism and bone health in sarcoidosis. Curr Opin Pulm Med. 2017;23(5):476–81.
4. Baughman RP, Field S, Costabel U, Crystal RG, Culver DA, Drent M, et al. Sarcoidosis in America: Analysis based on health care use. Ann Am Thorac Soc. 2016;13(8):1244–52.
5. Bennett D, Bargagli E, Refini RM, Rottoli P. New concepts in the pathogenesis of sarcoidosis. Expert Rev of Respir Med. Taylor & Francis; 2019. 981–991 p.
6. Rao DA. Extrapulmonary Manifestations of Sarcoidosis. Rheum Dis Clin North Am. 2013;39:1–36.
7. Grunewald J, Grutters JC, Arkema E V., Saketkoo LA, Moller DR, Müller-Quernheim J. Sarcoidosis. Nat Rev Dis Prim. 2019;5(1).
8. Timmermans WMC, van Laar JAM, van Hagen PM, van Zelm MC. Immunopathogenesis of granulomas in chronic autoinflammatory diseases. Clin Transl Immunol. 2016;5(12):118.
9. Bikle D. Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. Chem Biol. 2014;21(3):319–29.
10. Ungprasert P, Carmona E, Crowson C, Matteson E. Diagnostic Utility of Angiotensin Converting Enzyme in Sarcoidosis: A Population-Based Study. Lung. 2016;194(1):91–5.
11. Mañá J, Marcoval J. Skin manifestations of sarcoidosis. Press Med. 2012;41(6):355–74.
12. Adams JS, Hewison M. Extrarenal expression of the 25-hydroxyvitamin D-1-hydroxylase. Arch Biochem Biophys. 2012;523(1):95–102.
13. Bolland MJ, Wilsher ML, Grey A, Horne AM, Fenwick S, Gamble GD, et al. Randomised controlled trial of vitamin D supplementation in sarcoidosis. BMJ Open. 2013;3:1–8.
14. Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: A helpful immuno-modulator. Immunology. 2011;134(2):123–39.
15. Conron M, Young C, Beynon HLC. Calcium metabolism in sarcoidosis and its clinical implications. Rheumatology. 2000;39(7):707–13.
16. Tsiaras WG, Weinstock MA. Factors influencing vitamin d status. Acta Derm Venereol. 2011;91(2):115–24.
17. Papanikolaou IC, Tabila B, Tabila K, Borok Z, Sharma O, Gould MK. Vitamin D status in sarcoidosis: A cross-sectional study. Sarcoidosis Vasc Diffus Lung Dis. 2018;35(2):154–9.
18. Sodhi A, Aldrich T. Vitamin D Supplementation: Not So Simple in Sarcoidosis. Am J Med Sci. 2016;352(3):252–7.
19. Kiani A, Abedini A, Adcock IM, Mirenayat MS, Taghavi K, Mortaz E, et al. Association Between Vitamin D Deficiencies in Sarcoidosis with Disease Activity, Course of Disease and Stages of Lung Involvements. J Med Biochem. 2018;37(2):103–9.
20. Kamphuis LS, Bonte-Mineur F, Van Laar JA, Van Hagen PM, Van Daele PL. Calcium and Vitamin D in Sarcoidosis:Is supplementation safe? J Bone Miner Res. 2014;29(11 S1):2498–503.
21. Kavathia D, Buckley JD, Rao D, Rybicki B, Burke R. Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respir Med. 2010;104(4):564–70.
22. Liu P, Strenger S, Li H, Wenzel L, Tan B, Krutzik S. Toll-Like Receptor Triggering of a Vitamin D–Mediated Human Antimicrobial Response. Sciene. 2006;311:1770–3.
23. Richmond BW, Drake WP. Vitamin D, innate immunity, and sarcoidosis granulomatous inflammation: Insights from mycobacterial research. Curr Opin Pulm Med. 2010;16(5):461–4.
24. Kanchwala AA, Barna BP, Singh RJ, Culver DA, Malur A, Abraham S, et al. Deficiencies of Cathelicidin and Vitamin D Accompany Disease Severity in Sarcoidosis. Chest. 2009;136(4):127.
25. Capolongo G, Xu LHR, Accardo M, Sanduzzi A, Stanziola AA, Colao A, et al. Vitamin-D status and mineral metabolism in two ethnic populations with sarcoidosis. J Investig Med. 2016;64(5):1025–34.
26. Rizzato G, Tosi G, Mella C, Montemurro L, Zanni D, Sisti S. Prednisone-induced bone loss in sarcoidosis: a risk especially frequent in postmenopausal women. Sarcoidosis. 1988;5(2):93–8.
27. Majumdar SR, Lix LM, Yogendran M, Morin SN, Metge CJ, Leslie WD. Population-based trends in osteoporosis management after new initiations of long-term systemic glucocorticoids. J Clin Endocrinol Metab. 2012;97(4):1236–42.
28. Stern PH, Olazabal JD, Bell NH. Evidence for abnormal regulation of circulating 1α,25-dihydroxyvitamin D in patients with pulmonary tuberculosis and normal calcium metabolism. Calcif Tissue Int. 1984;36(1):541–4.
29. Overton C, Iden T, Syed A, Kashiouris M, Syed H. Effect of Vitamin D Supplementation on Calcium Levels in Patients with Sarcoidosis: A Retrospective Analysis. Arthritis Rheumatol. 2019;71.
30. Robertson AP, Weinreb A, Weinreb JE. Protection of Bone Density in Sarcoidosis: Can We Give Vitamin D Without Causing Hypercalcemia? AACE Clin Case Reports. 2017;3(4):349–52.
2. Burke R, Rybiciki B, Rao D. Calcium and vitamin D in sarcoidosis: How to assess and manage. Semin Respir Crit Care Med. 2010;31(4):474–84.
3. Baughman RP, Papanikolaou I. Current concepts regarding calcium metabolism and bone health in sarcoidosis. Curr Opin Pulm Med. 2017;23(5):476–81.
4. Baughman RP, Field S, Costabel U, Crystal RG, Culver DA, Drent M, et al. Sarcoidosis in America: Analysis based on health care use. Ann Am Thorac Soc. 2016;13(8):1244–52.
5. Bennett D, Bargagli E, Refini RM, Rottoli P. New concepts in the pathogenesis of sarcoidosis. Expert Rev of Respir Med. Taylor & Francis; 2019. 981–991 p.
6. Rao DA. Extrapulmonary Manifestations of Sarcoidosis. Rheum Dis Clin North Am. 2013;39:1–36.
7. Grunewald J, Grutters JC, Arkema E V., Saketkoo LA, Moller DR, Müller-Quernheim J. Sarcoidosis. Nat Rev Dis Prim. 2019;5(1).
8. Timmermans WMC, van Laar JAM, van Hagen PM, van Zelm MC. Immunopathogenesis of granulomas in chronic autoinflammatory diseases. Clin Transl Immunol. 2016;5(12):118.
9. Bikle D. Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. Chem Biol. 2014;21(3):319–29.
10. Ungprasert P, Carmona E, Crowson C, Matteson E. Diagnostic Utility of Angiotensin Converting Enzyme in Sarcoidosis: A Population-Based Study. Lung. 2016;194(1):91–5.
11. Mañá J, Marcoval J. Skin manifestations of sarcoidosis. Press Med. 2012;41(6):355–74.
12. Adams JS, Hewison M. Extrarenal expression of the 25-hydroxyvitamin D-1-hydroxylase. Arch Biochem Biophys. 2012;523(1):95–102.
13. Bolland MJ, Wilsher ML, Grey A, Horne AM, Fenwick S, Gamble GD, et al. Randomised controlled trial of vitamin D supplementation in sarcoidosis. BMJ Open. 2013;3:1–8.
14. Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: A helpful immuno-modulator. Immunology. 2011;134(2):123–39.
15. Conron M, Young C, Beynon HLC. Calcium metabolism in sarcoidosis and its clinical implications. Rheumatology. 2000;39(7):707–13.
16. Tsiaras WG, Weinstock MA. Factors influencing vitamin d status. Acta Derm Venereol. 2011;91(2):115–24.
17. Papanikolaou IC, Tabila B, Tabila K, Borok Z, Sharma O, Gould MK. Vitamin D status in sarcoidosis: A cross-sectional study. Sarcoidosis Vasc Diffus Lung Dis. 2018;35(2):154–9.
18. Sodhi A, Aldrich T. Vitamin D Supplementation: Not So Simple in Sarcoidosis. Am J Med Sci. 2016;352(3):252–7.
19. Kiani A, Abedini A, Adcock IM, Mirenayat MS, Taghavi K, Mortaz E, et al. Association Between Vitamin D Deficiencies in Sarcoidosis with Disease Activity, Course of Disease and Stages of Lung Involvements. J Med Biochem. 2018;37(2):103–9.
20. Kamphuis LS, Bonte-Mineur F, Van Laar JA, Van Hagen PM, Van Daele PL. Calcium and Vitamin D in Sarcoidosis:Is supplementation safe? J Bone Miner Res. 2014;29(11 S1):2498–503.
21. Kavathia D, Buckley JD, Rao D, Rybicki B, Burke R. Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respir Med. 2010;104(4):564–70.
22. Liu P, Strenger S, Li H, Wenzel L, Tan B, Krutzik S. Toll-Like Receptor Triggering of a Vitamin D–Mediated Human Antimicrobial Response. Sciene. 2006;311:1770–3.
23. Richmond BW, Drake WP. Vitamin D, innate immunity, and sarcoidosis granulomatous inflammation: Insights from mycobacterial research. Curr Opin Pulm Med. 2010;16(5):461–4.
24. Kanchwala AA, Barna BP, Singh RJ, Culver DA, Malur A, Abraham S, et al. Deficiencies of Cathelicidin and Vitamin D Accompany Disease Severity in Sarcoidosis. Chest. 2009;136(4):127.
25. Capolongo G, Xu LHR, Accardo M, Sanduzzi A, Stanziola AA, Colao A, et al. Vitamin-D status and mineral metabolism in two ethnic populations with sarcoidosis. J Investig Med. 2016;64(5):1025–34.
26. Rizzato G, Tosi G, Mella C, Montemurro L, Zanni D, Sisti S. Prednisone-induced bone loss in sarcoidosis: a risk especially frequent in postmenopausal women. Sarcoidosis. 1988;5(2):93–8.
27. Majumdar SR, Lix LM, Yogendran M, Morin SN, Metge CJ, Leslie WD. Population-based trends in osteoporosis management after new initiations of long-term systemic glucocorticoids. J Clin Endocrinol Metab. 2012;97(4):1236–42.
28. Stern PH, Olazabal JD, Bell NH. Evidence for abnormal regulation of circulating 1α,25-dihydroxyvitamin D in patients with pulmonary tuberculosis and normal calcium metabolism. Calcif Tissue Int. 1984;36(1):541–4.
29. Overton C, Iden T, Syed A, Kashiouris M, Syed H. Effect of Vitamin D Supplementation on Calcium Levels in Patients with Sarcoidosis: A Retrospective Analysis. Arthritis Rheumatol. 2019;71.
30. Robertson AP, Weinreb A, Weinreb JE. Protection of Bone Density in Sarcoidosis: Can We Give Vitamin D Without Causing Hypercalcemia? AACE Clin Case Reports. 2017;3(4):349–52.
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Published
2023-07-03
How to Cite
Ramadhiani, M., Irawan, Y., Yusharyahya, S. N., & Legiawati, L. (2023). PERAN SUPLEMENTASI VITAMIN D PADA TATA LAKSANA SARKOIDOSIS KUTIS. Media Dermato-Venereologica Indonesiana, 50(1), 25–31. https://doi.org/10.33820/mdvi.v49i4.311
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