Kang Eun Seok, Do Mi Young, Park So Young, Hur Kyu Yeon, Ahn Chul Woo, Cha Bong Soo, Lim Sung Kil, Kim Kyung Rae, Lee Hyun Chul
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Am J Trop Med Hyg. 2005 Apr;72(4):368-9.
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.
