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Resolution of Hypercalcemia and Acute Kidney Injury After Treatment for Pulmonary Tuberculosis Without the Use of Corticosteroids

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  • Division of Nephrology, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará, Brazil; Division of Nephrology, Hospital Universitário Walter Cantídio, Fortaleza, Ceará, Brazil; Universidade de Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
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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.

Author Notes

* Address correspondence to Sonia M. H. A. Araujo, Rua Professor Costa Mendes, n° 2609, CEP 60430-040 Fortaleza, CE, Brazil. E-mail: sholanda.almeidaaraujo@gmail.com

Authors' addresses: Constance A. A. Araujo, Nicole A. A. Araujo, José Daniel B. Oliveira, and Elizabeth F. Daher, Department of Medicine, Universidade Federal do Ceara, Fortaleza, Ceara, Brazil, E-mails: constancedealencar@gmail.com, nicoledealencar@gmail.com, zedaniel.med@gmail.com, and ef.daher@uol.com.br. Marcos Kubrusly, Pastora M. A. Duarte, Sonia L. Silva, and Sonia M. H. A. Araujo, Division of Nephrology, Hospital Universitário Walter Cantidio, Fortaleza, Brazil, E-mails: marcoskubrusly@fortalnet.com.br, fb.duarte@terra.com.br, sonials@unifor.br, and sholanda.almeidaaraujo@gmail.com.

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