Autor(es): Araujo, Constance A. A. ; Araujo, Nicole A. A. ; Daher, Elizabeth de Francesco ; Oliveira, José Daniel B. ; Kubrusly, Marcos ; Duarte, Pastora M. A. ; Silva, Sonia L. ; Araujo, Sonia Maria Holanda Almeida
Data: 2014
Origem: Oasisbr
Assunto(s): Hipercalcemia; Tuberculose Pulmonar; Corticosteróides
Hypercalcemia caused by tuberculosis is rare and it is usually asymptomatic. Tuberculosis (TB) -related hypercalcemia associated with acute kidney injury (AKI) is rarely reported. We report a case of a 22-year-old immunocompetent man with 1-month history of daily fever, asthenia and weight loss. Laboratory findings on admission included serum calcium 14.9 mg/dL, urinary Ca2+ 569.6 mg/24 hours, low level of parathyroid hormone, serum creatinine = 2.2 mg/dL and sodium fractional excretion (FeNa) 2.73%. The result of the tuberculin skin test was 17 mm. A chest X-ray revealed micronodular pulmonary infiltrate in the apex of the right lung, which was confirmed by computed tomography scan. The patient was diagnosed with hypercalcemia associated with pulmonary TB and AKI. A general improvement of the hypercalcemia and renal function was observed in the first 2 weeks after effective hydration and treatment of TB without corticosteroids. The patient was discharged with normal calcium levels and renal function.
