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Hypercalcemia in coccidioidomycosis.

M S Parker, S Dokoh, J M Woolfenden

    The American Journal of Medicine
    |February 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

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    Disseminated coccidioidomycosis can cause hypercalcemia by affecting vitamin D metabolism. This study suggests a possible osteotropic substance contributing to high calcium levels in these patients.

    Area of Science:

    • Endocrinology
    • Mycology
    • Nephrology

    Background:

    • Disseminated coccidioidomycosis is a fungal infection that can affect multiple organ systems.
    • Hypercalcemia, or high blood calcium, is a potential complication of disseminated fungal infections.
    • Understanding the mechanisms of hypercalcemia in coccidioidomycosis is crucial for patient management.

    Observation:

    • Two patients with disseminated coccidioidomycosis presented with significant hypercalcemia.
    • One patient exhibited normal 25-hydroxyvitamin D but low 1 alpha,25-dihydroxyvitamin D levels.
    • Serum parathyroid hormone was suppressed, while nephrogenous cyclic AMP was elevated, indicating abnormal calcium regulation.

    Findings:

    • Despite a low calcium diet, hypercalcemia and hypercalciuria persisted in the studied patients.

    Related Experiment Videos

  • Intestinal calcium absorption was markedly elevated at 63%.
  • Hormonal assays showed appropriate calcitonin levels for the high serum calcium and suppressed parathyroid hormone.

    • Implications:

    • The findings suggest a potential role for an unknown osteotropic substance, similar to that seen in humoral hypercalcemia of malignancy, in causing hypercalcemia in disseminated coccidioidomycosis.
    • Further research is warranted to identify this substance and its mechanism of action.
    • This understanding could lead to novel therapeutic strategies for managing hypercalcemia in this severe fungal infection.