There are many established causes of hypercalcemia. These include hyperparathyroidism, malignancies with or without bony metastases, sarcoidosis, bone atrophy, thyroid dysfunction, Addison disease, vitamin D intoxication, and the milk-alkali syndrome.1 Hypercalcemia with disseminated bone tuberculosis is extremely rare. However, a case of miliary tuberculosis in which symptomatic hypercalcemia developed was reversed by corticosteroid therapy.
A 28-year-old officer began serving a tour of duty in the Republic of Vietnam in September 1969. In March 1970, the patient noted the onset of fever, chills, nausea, and vomiting. A chest roentgenogram was normal, and peripheral blood smears revealed falciparum malaria. Despite several courses of antimalarial therapy and clearing of the parasitemia, fever persisted; and in late May, he was transferred to Walter Reed General Hospital.On admission, the patient complained of weakness, anorexia, and had a 9.04-kg weight loss. He was a thin, chronically ill appearing, white man in no
Braman SS, Goldman AL, Schwarz MI. Steroid-Responsive Hypercalcemia in Disseminated Bone Tuberculosis. Arch Intern Med. 1973;132(2):269-271. doi:10.1001/archinte.1973.03650080113022