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[Hypercalcemia in florid pulmonary and cervical lymph node tuberculosis]
I Meuthen1, L Kirsch, F Saborowski
1Medizinische Klinik, Städtisches Krankenhaus Köln-Holweide.
Deutsche Medizinische Wochenschrift (1946)
|June 7, 1991
Summary
This case study describes TB-associated hypercalcaemia in a patient with a history of tuberculosis. The hypercalcaemia was not linked to vitamin D or bone destruction, highlighting a unique presentation of tuberculosis complications.
Area of Science:
- Endocrinology
- Infectious Diseases
- Oncology
Background:
- Tuberculosis (TB) can present with diverse extrapulmonary manifestations.
- Hypercalcaemia is a rare complication of TB, with its exact pathogenesis often unclear.
- Previous TB history and poor drug compliance can predispose individuals to recurrent or disseminated disease.
Observation:
- A 57-year-old male with prior TB history presented with weight loss, cervical lymphadenopathy, and skin fistula.
- Laboratory findings revealed mild hypercalcaemia, hyperphosphataemia, and reduced 1,25-dihydroxy-vitamin D3 levels.
- Histopathology confirmed active caseous lymph node tuberculosis.
Findings:
- Tuberculostatic treatment initiated with standard multi-drug regimen.
- Serum calcium levels significantly increased during the initial two weeks of treatment, despite a low-calcium diet.
- Hypercalcaemia persisted, albeit at lower levels, throughout the 11-week observation period.
Implications:
- This case suggests a non-classical mechanism for TB-associated hypercalcaemia, independent of 1,25-dihydroxy-vitamin D3 or bone destruction.
- Highlights the importance of considering atypical presentations of TB, even in patients with a remote history of the disease.
- Further research is needed to elucidate the specific pathways involved in this unique form of hypercalcaemia.