PTHLH and hypercalcemia disease: In sarcoidosis, alternative hypercalcemia mechanisms suggest stimulation of 1-alpha hydroxylase by release of parathyroid hormone-related protein (PTH-rP) and increased excretion of interferon-γ. As a result, expression of parathyroid hormone (PTH) is suppressed, and due to elevated kidney calcium clearance that exceeds the reabsorption ability, hypercalciuria occurs [17,24].