Hypercalcemia and Elevated 1,25-Dihydroxyvitamin D Levels in a Patient with End-Stage Renal Disease and Active Tuberculosis

Abstract

HYPERCALCEMIA has been reported to occur in association with several granulomatous disorders, including sarcoidosis, tuberculosis, fungal infections, and chronic beryllium disease.^{1 2 3 4} Recent reports suggest that extrarenal production of 1,25-dihydroxyvitamin D (1,25-(OH)₂D) is involved in the pathogenesis of the hypercalcemia of sarcoidosis. These reports include an anephric patient⁵ and a patient with end-stage renal disease⁶ (both of whom were on hemodialysis) who had sarcoidosis, hypercalcemia, and elevated 1,25-(OH)₂D levels. Although no such reports are available in the case of tuberculosis, some studies have suggested that hypercalcemia is more likely to occur in patients with tuberculosis who are . . .