Division of Nephrology, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
Am J Trop Med Hyg. 2013 Mar;88(3):592-5. doi: 10.4269/ajtmh.11-0768. Epub 2013 Jan 21.
Abstract. 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 Ca(2+) 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.
摘要。由结核病引起的高钙血症很少见，且通常无症状。与急性肾损伤（AKI）相关的结核病（TB）相关高钙血症很少见。我们报告了一例 22 岁免疫功能正常的男性，有 1 个月的每日发热、乏力和体重减轻病史。入院时的实验室检查结果包括血清钙 14.9mg/dL、尿钙 569.6mg/24 小时、甲状旁腺激素水平低、血清肌酐 = 2.2mg/dL 和钠分数排泄（FeNa）2.73%。结核菌素皮肤试验结果为 17mm。胸部 X 线显示右肺尖部微结节性肺部浸润，经计算机断层扫描证实。该患者被诊断为与肺结核和 AKI 相关的高钙血症。在有效水化和抗结核治疗（不使用皮质类固醇）后的前 2 周，高钙血症和肾功能得到了整体改善。患者出院时血钙水平和肾功能正常。
