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  • Title: [Abnormal synthesis of 1,25-dihydroxyvitamin D and hypercalcemia in children with tuberculosis].
    Author: Saggese G, Bertelloni S, Baroncelli GI, Fusaro C, Gualtieri M.
    Journal: Pediatr Med Chir; 1989; 11(5):529-32. PubMed ID: 2631059.
    Abstract:
    Three children with tuberculosis and hypercalcemia are reported. Before antitubercular treatment 1,25-dihydroxyvitamin D serum levels and urinary calcium excretion were elevated for age in all patients; vitamin D and 25-hydroxyvitamin D were in normal range whereas serum intact parathyroid hormone concentrations were suppressed. Low calcium diet and antitubercular treatment caused a normalization of serum calcium levels and urinary calcium excretion; 1,25-dihydroxyvitamin D concentrations returned in normal range after three months of antituberculosis therapy. When 1,25-dihydroxyvitamin D was normal, a reintroduction of a diet with normal calcium content did not determine new hypercalcemic episodes. These data suggest that an abnormal 1,25-dihydroxyvitamin D production sustains the hypercalcemia of children with tuberculosis. An ectopic and unregulated synthesis of 1,25-dihydroxyvitamin D by macrophages of granulomatous tissue is proposed.
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