Hypercalcaemia and elevated 1,25(OH)(2)D-3 levels associated with disseminated Mycobacterium avium infection in AIDS

Hypercalcaemia may complicate granulomatous diseases, such as tuberculosis and sarcoidosis, and various AIDS-related opportunistic infections and mali gnancies. We report here two patients with AIDS and disseminated Mycobacter ium avium infection who developed symptomatic hypercalcaemia several weeks after commencing antimycobacterial chemotherapy, and in whom inappropriatel y elevated 1,25(OH)(2)D-3 levels were documented, Although vitamin D supple mentation may have contributed, no other cause for the hypercalcaemia was f ound, The biochemical and clinical similarities between these cases and oth er hypercalcaemic granulomatous diseases suggest a common mechanism related to macrophage activation and dysregulated Vitamin D production. (C) 2001 T he British Infection Society.