Hyperuricaemia, Hypoparathyroidism and Acute Hypercalcaemia: Unusual Complications in Extrapulmonary Tuberculosis

Parkash, Ravi; Dabla, Surekha; Saini, Neharika; Bala, Kiran

doi:10.7860/jcdr/2019/41664.13112

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2021

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“…A theory has been proposed that hypercalcemia in tuberculous pleural effusion could be secondary to circulating monocytes, which act as a source of 1- α -hydroxylase that could convert 25(OH)D 3 to 1,25(OH) 2 D 3 . This 1,25(OH) 2 D 3 produced by monocytes acts locally and when carried to target tissues, it may play a role in calcium homeostasis, unlike alveolar immune cells which only acts locally [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Denosumab as the Treatment of Recalcitrant Tuberculous Pleural Effusion-Associated Hypercalcemia

Jalil

Hatta

Mohamad

et al. 2021

Case Reports in Medicine

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Denosumab is a human monoclonal antibody that binds to RANKL (receptor activator of nuclear factor-kappa B ligand). It has mainly been used in the treatment of osteoporosis for a variety of causes especially in situations refractory to bisphosphonates or when kidney function is impaired. It is also used in cases of malignancy-associated hypercalcemia. There are many causes of hypercalcemia, but only rarely it is associated with granulomatous diseases such as tuberculous pleural effusion. We report a case of hypercalcemia from tuberculous pleural effusion that was initially admitted with left medium abundance pleural effusion and a serum corrected calcium level of 3.48 mmol/L. The calcium level was successfully normalized within 72 hours of subcutaneous denosumab administration after other interventions have failed.

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Section: Discussionmentioning

confidence: 99%