Volume 72, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Although primary hyperparathyroidism and malignant diseases account for approximately 90% of the causes of hypercalcemia, they could occur in association with granulomatous diseases such as tuberculosis or sarcoidosis, especially in developing countries. Hepatic tuberculosis is difficult to diagnosis without suspicion in cases with normal findings on chest radiographs. We report a 70-year-old woman who presented with hypercalcemia due to hepatic tuberculosis. The diagnosis was made by a computed tomography scan and laparoscopic evaluation. After treatment with anti-tuberculosis medication, her hypercalcemia resolved. Increased vitamin D synthesis by activated macrophages in the granuloma tissue is the major mechanism of hypercalcemia in tuberculosis.


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  1. Abbasi AA, Chempavil JK, Farah S, Muller BF, Arnstein AR, 1979. Hypercalcemia in active pulmonary tuberculosis. Ann Intern Med 90 : 324–328. [Google Scholar]
  2. Sharma SC, 1981. Serum calcium in pulmonary tuberculosis. Postgrad Med J 57 : 694–696. [Google Scholar]
  3. Roussos A, Lagogianni I, Gonis A, Ilias I, Kazi D, Patsopoulos D, Philippou N, 2001. Hypercalcemia in Greek patients with tuberculosis before the initiation of anti-tuberculosis treatment. Respir Med 95 : 187–190. [Google Scholar]
  4. Tobias H, Sherman A, 1996. Hepatobiliary tuberculosis. Rom WN, Garay SM, Bloom M, eds. Tuberculosis. First edition. Boston: Little, Brown and Company, 599–608.
  5. Alvarez SZ, 1998. Hepatobiliary tuberculosis. J Gastroenterol Hepatol 13 : 833–839. [Google Scholar]
  6. Mert A, Ozaras R, Tabak F, Ozturk R, Bilir M, 2003. Localized hepatic tuberculosis (letter). Eur J Intern Med 14 : 511–512. [Google Scholar]
  7. Fisken RA, Heath DA, Somers S, Bold AM, 1981. Hypercalcemia in hospital patients: clinical and diagnostic aspects. Lancet 1 : 202–207. [Google Scholar]
  8. Shek CC, Natkunam A, Tasng V, Cockram CS, Swaminathan R, 1990. Incidence, causes and mechanism of hypercalcemia in a hospital population in Hong Kong. QJM 284 : 1277–1285. [Google Scholar]
  9. Sharma OP, 2000. Hypercalcemia in granulomatous disorders: a clinical review. Curr Opin Pulm Med 6 : 442–447. [Google Scholar]
  10. Rook G, 1988. The role of vitamin D in tuberculosis. Am Rev Resp Dis 138 : 768–770. [Google Scholar]
  11. Need AG, Phillips PJ, Chiu FTS, Prisk HM, 1980. Hypercalcemia associated with tuberculosis. BMJ 280 : 831. [Google Scholar]
  12. Liam CK, Lim KH, Srinivas P, Poi PJH, 1998. Hypercalcemia in patients with newly diagnosed tuberculosis in Malaysia. Int J Tuberc Lung Dis 2 : 818–823. [Google Scholar]
  13. Essop AR, Posen JA, Hodkinson JH, Segal I, 1984. Tuberculosis hepatitis, a clinical review of 96 cases. QJM 212 : 465–477. [Google Scholar]

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  • Received : 06 Oct 2004
  • Accepted : 23 Nov 2004

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