ISSN: 2148-4902 | E-ISSN: 2536-4553
Successful management with bisphosphonate treatment in a child with tuberculosis-associated hypercalcemia [North Clin Istanb]
North Clin Istanb. Ahead of Print: NCI-14890 | DOI: 10.14744/nci.2019.14890

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

Suna Kılınç1, Özlem Bostan Gayret2, Meltem Erol2, Saide Ertürk3, tugce damla Dilek2, Özgül Yiğit2
1Department of Pediatric Endocrinology, Istanbul Bağcılar Education and Research Hospital, Istanbul, Turkey
2Department of Pediatrics, Istanbul Bağcılar Education and Research Hospital, Istanbul, Turkey.
3Department of Pediatrics, Istanbul Esenler Obstetrics and Pediatrics Hospital, Istanbul, Turkey.

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

Keywords: Hypercalcemia, miliary tuberculosis, bisphosphonates, pamidronate-disodium

Tüberküloz ilişkili hiperkalsemi saptanan bir olguda bifosfonat tedavisi ile başarılı yönetim

Suna Kılınç1, Özlem Bostan Gayret2, Meltem Erol2, Saide Ertürk3, tugce damla Dilek2, Özgül Yiğit2
1Department of Pediatric Endocrinology, Istanbul Bağcılar Education and Research Hospital, Istanbul, Turkey
2Department of Pediatrics, Istanbul Bağcılar Education and Research Hospital, Istanbul, Turkey.
3Department of Pediatrics, Istanbul Esenler Obstetrics and Pediatrics Hospital, Istanbul, Turkey.

Hiperkalsemi çocuklarda sık görülen metabolik bir bozukluktur ve genellikle hiperparatiroidizm, D vitamini toksisitesi, bazı genetik bozukluklar ve malign hastalıklar nedeniyle oluşur. Çocuklarda hiperkalseminin nadir bir nedeni olan granülomatöz hastalıklar ise genellikle hafif ve asemptomatik hiperkalsemi sebebidir. Literatürde granülomatöz hastalıklarda nadiren semptomatik ağır hiperkalsemi bildirilmiştir. Burada, milier tüberküloza sekonder ağır hiperkalsemi ile başvuran ve bifosfanat tedavisi ile normal kalsiyum düzeyi sağlanan bir çocuk olgu sunulmaktadır. Tüberkülozda gelişen hiperkalseminin ana mekanizmasının granülom dokusunda aktif makrofajlar ile 1,25 (OH) 2D3 sentezinin artması olduğu düşünülmektedir.

Anahtar Kelimeler: Hiperkalsemi, milier tüberküloz, bisfosfonatlar, pamidronat-disodyum



Corresponding Author: Suna Kılınç

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