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October 30, 1972

Hypercalcemia and Tuberculosis

Author Affiliations

University of Southern California Los Angeles

JAMA. 1972;222(5):582. doi:10.1001/jama.1972.03210050054016

To the Editor.—  Hypercalcemia is an unusual finding in tuberculosis. At this medical center, we have recently seen a transient hypercalcemia in a patient with tuberculosis.

Report of a Case.—  A 24-year-old Indian was admitted to the general medical ward from a tuberculosis care center because of an elevated serum calcium level. The diagnosis of tuberculosis was made six weeks earlier on the basis of a history of fever and weight loss, x-ray films of the chest consistent with a miliary process, positive intermediate strength purified protein derivative (PPD), and a positive sputum culture for acid-fast bacillus. Chemotherapy consisted of isoniazid, streptomycin, pyridoxine, and PAS (powder—not the calcium salt). The SMA-12 detected two hypercalcemic sera, and transfer to the medical service was subsequently recommended. The hypercalcemia, in addition to azotemia and elevated creatinine level, was confirmed on initial work-up. Significant laboratory data appear in the Table.Sarcoidosis was ruled out