Hypercalcemia caused by comorbid parathyroid adenoma and pulmonary tuberculosis.

Abstract

Hypercalcemia is usually secondary to one etiology, although two coexisting etiologies can rarely cause hypercalcemia. Here, we report a 47-year-old woman with hypercalcemia caused by comorbid parathyroid adenoma and pulmonary tuberculosis. Primary hyperparathyroidism is the most common cause of hypercalcemia. Tuberculosis is a rare cause of hypercalcemia, but Japan continues to have an intermediate tuberculosis burden. Therefore, tuberculosis should be considered as a cause of hypercalcemia in Japan. Patients with tuberculosis are often asymptomatic, making the diagnosis difficult. In the previous cases in which these diseases coexisted, one disease was diagnosed after treatment of the other. In our case, the very high 1,25-dihydroxyvitamin D level (162 pg/mL) helped us to diagnose asymptomatic tuberculosis and both diseases were diagnosed promptly. It is necessary to consider comorbidities, including tuberculosis in a case with a very high 1,25-dihydroxyvitamin D level. We report a valuable case in which the early diagnosis and treatment of tuberculosis and primary hyperparathyroidism prevented the spread of tuberculosis.

• Authors: Sahoko Kamejima, Izumi Yamamoto, Arisa Kobayashi, Akio Nakashima, Taketo Uchiyama, Ichiro Ohkido, Takashi Yokoo
• Journal: CEN case reports (CEN Case Rep) Vol. 10 Issue 1 Pg. 1-5 (02 2021) ISSN: 2192-4449 [Electronic] Japan
• PMID: 32632908 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antitubercular Agents
• Vitamin D
• 1,25-dihydroxyvitamin D

Topics

• Antitubercular Agents (therapeutic use)
• Bone Density (drug effects)
• Comorbidity
• Early Diagnosis
• Female
• Humans
• Hypercalcemia (diagnosis, etiology)
• Hyperparathyroidism, Primary (diagnosis, drug therapy)
• Middle Aged
• Parathyroid Neoplasms (complications, diagnosis, surgery)
• Parathyroidectomy (methods)
• Treatment Outcome
• Tuberculosis, Pulmonary (complications, diagnosis, drug therapy)
• Vitamin D (analogs & derivatives, blood)