Hypercalcemia of unusual etiology: A case report

Abstract

A 71-year-old lady, known to have diabetes and hypertension, was evaluated for a history of fever and tiredness for a few weeks. She had drug-induced hypokalemia due to chlorthalidone that she was taking for hypertension, and it was corrected. Further investigations revealed hypercalcemia of 11.3 mg/dL, which rose to 14.4 mg/dL in a few days. Parathyroid hormone level was low. Her respiratory evaluation showed granulomatous features in the lungs in PET-CT scan and GeneXpert for tuberculosis in urine, and bronchoalveolar lavage fluid was positive, suggestive of disseminated tuberculosis. Her serum calcium was reduced with zoledronic acid given for emergency treatment of hypercalcemia and reached a normal level within 6 days and was maintained within normal limits by 3 weeks of starting antituberculosis treatment. This is a case of tuberculosis-induced hypercalcemia.