Hypercalcemic crisis in a patient with pulmonary tuberculosis

Hypercalcemia occurs in 16% to 28% of patients with pulmonary tuberculosis. Rarely, however, does the calcium rise to a level that requires emergency management. In this report, a 49-year-old woman undergoing treatment for pulmonary tuberculosis presented with vomiting and weakness secondary to severe hypercalcemia. Although the pathophysiology of hypercalcemia in this setting is not completely understood, the management is similar to hypercalcemic crisis from other causes. Physicians must maintain a high index of suspicion since prompt recognition and therapy will ensure a successful outcome.