Hypercalcaemia in Greek patients with tuberculosis before the initiation of anti-tuberculosis treatment

Hypercalcaemia has been known to occur in association with granulomatous di seases. The aim of this study was to ascertain the incidence of hypercalcae mia and determine the prevalence of symptoms associated with it in Greek pa tients with newly-diagnosed tuberculosis (TB), before the initiation of ant i-tuberculosis treatment. We prospectively evaluated all patients with newl y-diagnosed TB presenting, either as inpatients or as outpatients, to our h ospital, during a 3-year period. We evaluated 88 patients with TB (50 males and 38 females), aged between 23 and 89 years (mean age+/-SD: 46.4+/-19 ye ars), and 65 age- and sex-matched controls with chronic obstructive pulmona ry disease (36 males and 29 females), aged between 28 and 88 years (mean ag e+/-SD: 47.2+/-18 years). Among TB patients, 56 had pulmonary TB, 20 had pl eural TB without evidence of pulmonary parenchyma involvement, eight had pu lmonary and pleural TB, and four had disseminated disease. The mean (+/-SD) albumin-adjusted serum calcium concentration and the mean ionized calcium concentration were significantly higher in the TB group (2. 49+/-0.21 mmol 1(-1) and 1.27+/-0.02 mmol 1(-1) respectively) than in the c ontrol group (2.36+/-0.11 mmol 1(-1) and 1.19+/-0.02 mmol 1(-1), P < 0.05). In the TB group no correlation between type of disease and albumin-adjuste d or ionized calcium concentration was seen. Hypercalcaemia was detected in 22 patients with TB (25%) but only three showed symptoms associated with i t. We conclude that, although hypercalcaemia is a common laboratory finding among creek patients with TB before anti-TB chemotherapy, it is usually as ymtomatic.