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Nephrol Dial Transplant (2000) 15: 2046-2049
© 2000 European Renal Association-European Dialysis and Transplant Association

Case Report

Severe hypercalcaemia with normal serum calcitriol in a diabetic patient with chronic renal failure, autoimmune hepatitis and disseminated tuberculosis

Tzung-Hai Yen, Jeng-Yi Huang, Ching-Herng Wu1, Kam-Fai Lee and Chiu-Ching Huang

Division of Nephrology, Department of Internal Medicine and 1 Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China

Keywords: autoimmune hepatitis; calcitriol; disseminated tuberculosis; hypercalcaemia



   Introduction
 
The three most common causes of hypercalcaemia are primary hyperparathyroidism, malignancy and granulomatous disease. Hyperparathyroidism is the most common cause among patients outside of the hospital, while malignancy is the most common cause in hospital patients, hyperparathyroidism being the second [1]. However, Shek et al. found that tuberculosis-associated hypercalcaemia accounts for 6% of all cases of hypercalcaemia, representing, in their study, the second most common cause of hypercalcaemia [1]. Although the tuberculosis-associated hypercalcaemia is always mild, some reports of uraemic patients with disseminated tuberculosis have shown severe hypercalcaemia, which was attributed to elevated calcitriol levels [3–5]. In the present study, we report on an elderly woman with chronic renal insufficiency, autoimmune hepatitis, diabetes mellitus and chronic tophaceous gout who developed severe hypercalcaemia during regular clinical follow-up. Disseminated tuberculosis was diagnosed finally.



   Case
 
A 55-year-old woman had experienced chronic tophaceous arthritis for 4 . . . [Full Text of this Article]



   Discussion
 


   Conclusion
 


   Notes
 


   References
 

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