TNF and Hypercalcemia: Stimulated by interferon-γ (IFN- γ), tumor necrosis factor- α (TNF-α), interleukin-1 (IL1) and−2 (IL2), macrophages from sarcoid granulomas can spontaneously release 1,25-dihydroxy vitamin D, further boosting calcium resorption from the gastrointestinal tract and bone, leading to hypercalcemia and hypercalciuria (8, 9).