Successful management with bisphosphonate treatment in a child with tuberculosis-associated hypercalcemia

Abstract

Hypercalcemia is a common metabolic abnormality in children and generally occurs due to hyperparathyroidism, vitamin Dtoxicity, some genetic disorders and malignant diseases. Granulomatous diseases are a rare cause of hypercalcemia in children, which are usually mild and asymptomatic. Severe hypercalcemia in granulomatous diseases has also been reported inthe literature. Here, we report a child presenting with severe hypercalcemia secondary to miliary tuberculosis with successfulmanagement with bisphosphonate treatment. Increased 1,25(OH)2D3 synthesis by activated macrophages in the granulomatissue is the major mechanism of hypercalcemia in tuberculosis.