HYPERCALCEMIA: AN UNUSUAL PRESENTATION OF TUBERCULOSIS

Dr. Sadhna Sharma, Dr. Y. V. S. Prabhakar, Dr. K. Murali Mohan Rao, Dr. K. Sanjay, Dr. P . Karthik Varma

Abstract


Tuberculosis (TB), a granulomatous disease, is known to cause hypercalcemia. Hypercalcemia and its manifestations can be the presenting complaints in patients with active TB1. However, the incidence of hypercalcemia in TB patients is rare, with incidence ranging between 2% and 25%, of which very few are symptomatic. A 62 year old presented with symptoms of epigastric and loin pain, intermittent fevers, progressive swelling of both loer limbs, tarry stools, dyspnea, decreased urineoutput and significant weightloss. A chronic smoker and pain killer abuse.

Patient was found to have severe anemia due to iron deficiency with blood loss due to esophageal and duodenal ulcers, hypercalcemia, renal insufficiency. There was a suspicion of chronic kidney disease or malignancy. Further evaluation of hypercalcemia, lead us to a diagnosis of active pulmonary TB. Patient improved with aggressive hydration, hemodialysis with packed cell transfusion, parenteral iron, bisphosphonate and anti-tuberculosis therapy.


Keywords


Hypercalcemia, Tuberculosis, 1-alpha hydroxylase, Renal insufficiency, Granulomatous disease.

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References


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