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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
PubMed
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.

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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.

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  • 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.