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Biochemia Medica, Vol. 30 No. 3, 2020.

Other

https://doi.org/10.11613/BM.2020.030801

A rare case of tuberculosis-induced hypercalcemia

Loris Wauthier ; Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
Xavier Theunssens ; Department of Rheumatology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
Patrick Durez ; Department of Rheumatology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium; Pôle de Pathologies rhumatismales, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
Catherine Fillée ; Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
Diane Maisin ; Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
Damien Gruson ; Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium; Pôle de recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium

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Abstract

Laboratory investigations of hypercalcemia involve testing of various biochemical parameters such as parathyroid hormone (PTH), 25-(OH) Vitamin
D (25-(OH) VitD), 1,25-(OH)2 Vitamin D3 (calcitriol) and PTH related peptide (PTHrp).
We herein present an atypical case of severe hypercalcemia in a patient with rheumatoid arthritis who has been treated for years by various biological
disease-modifying antirheumatic drugs (DMARDs) and suddenly presented with general state alteration, oedema and ulceration of her right
ankle.
We illustrate how tuberculosis (TB) can cause high calcitriol concentration and subsequently lead to potentially severe hypercalcemia. Moreover, we
highlight the importance of TB testing and follow-up in patients treated with biological DMARDs.

Keywords

hypercalcemia; tuberculosis; rheumatoid polyarthritis; calcitriol

Hrčak ID:

244736

URI

https://hrcak.srce.hr/244736

Publication date:

15.10.2020.

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