Rizwan Azra, Islam Najmul
Department of Medicine, Aga Khan University & Hospital Stadium Road, Karachi 74800, P.O. Box 3500 Pakistan.
Cases J. 2009 Jul 6;2:6316. doi: 10.4076/1757-1626-2-6316.
55-year male of Asian descent presented with weight loss, lethargy, drowsiness and low grade fever without cough. Examination revealed crackles in the chest but no focal neurological deficit. Chest X ray revealed an infiltrate consistent with tuberculosis. Biopsy of infiltrate was negative for malignancy. Corrected calcium level revealed parathyroid independent hypercalcemia. Further diagnostic work up for drowsiness and hypercalcemia was normal. Despite receiving hydration and pharmacotherapy for his hypercalcemia, his condition failed to improve. When steroids were started, the patient's calcium levels and symptomatology resolved. Tuberculosis causing hypercalcemia is uncommon. Steroids are useful agents, particularly in refractory cases.
一名55岁的亚裔男性，出现体重减轻、乏力、嗜睡和低热，无咳嗽症状。检查发现胸部有啰音，但无局灶性神经功能缺损。胸部X光显示有与肺结核相符的浸润影。浸润影活检未发现恶性病变。校正钙水平显示为甲状旁腺非依赖性高钙血症。针对嗜睡和高钙血症的进一步诊断检查结果正常。尽管针对其高钙血症进行了补液和药物治疗，但其病情仍未改善。开始使用类固醇后，患者的钙水平和症状得到缓解。由肺结核引起的高钙血症并不常见。类固醇是有效的药物，尤其适用于难治性病例。
