Hanai Shogo, Shinzato Takashi, Inazu Daiki, Tokuda Yasuharu
Nakagami Byoin, Okinawa, Japan.
Department of Internal Medicine, Nakagami General Hospital, Okinawa, Japan.
BMJ Case Rep. 2017 Feb 24;2017:bcr2016217797. doi: 10.1136/bcr-2016-217797.
Many diseases can cause hypercalcaemia, including primary hyperparathyroidism, cancer, drugs and granulomatous diseases. A nursing home resident aged 81 years was admitted because of altered mental status. The patient did not have fever, cough, sputum or night sweat. Hypercalcaemia was identified as a cause of the consciousness disturbance. Chest radiograph showed no acute process. Laboratory workups revealed elevated serum levels of 1,25-(OH)2 vitamin D and positive T-spot test. Microscopic examination of the suctioned sputum identified acid-fast bacilli, which was confirmed as Tuberculosis should be considered as the important cause of hypercalcaemia since early diagnosis and treatment is recommended for preventing its outbreak among people with close contacts with patients.
许多疾病可导致高钙血症，包括原发性甲状旁腺功能亢进、癌症、药物和肉芽肿性疾病。一名81岁的养老院居民因精神状态改变入院。患者无发热、咳嗽、咳痰或盗汗。高钙血症被确定为意识障碍的一个原因。胸部X光片未显示急性病变。实验室检查显示血清1,25-(OH)2维生素D水平升高且T-SPOT试验呈阳性。对吸出痰液的显微镜检查发现抗酸杆菌，确诊为结核病。由于建议对与患者密切接触的人群进行早期诊断和治疗以预防其爆发，结核病应被视为高钙血症的重要原因。
