Ahmet Afşin KUNDAK, Resul YILMAZ, Haluk ESMERAY, Samet ÖZER, Nafia Özlem KAZANCI, Taner SEZER

Idiopathic infantile hypercalcemia or an extrapulmonary complication of tuberculosis?

Kalsiyum metabolizma bozukluklarına çocukluk çağında sık rastlanır. Bebeklik döneminde hiperkalsemi genellikle hiper- paratiroidizm, ailesel hipokalsiürik hiperkalsemi, cilt altı yağ nekrozu, total parenteral nütrisyon, hipertiroidizm ve adrenal yetmezliğe bağlı olarak ortaya çıkar. Tüberküloz ve sarkoidoz gibi granülomatöz hastalıklar nadir olarak hiperkalsemi ne- deni olarak saptanır. Nefrokalsinöz, beyin, göz, arter kalsifikasyonları ve ensefalopatik özellikler hiperkalseminin hayatı tehdit eden sonuçlarından bazılarıdır. Ciddi hiperkalsemi bulguları veren ve miliyer tüberküloz saptanan yedi aylık kız çocuğu hasta sunulmuştur.

İdiyopatik infantil hiperkalsemi mi, tüberkülozun ekstrapulmoner komplikasyonu mu?

Calcium metabolism disturbances are common in childhood. In infancy, hypercalcemia generally occurs due to hyperparathy- roidism, familial hypocalciuric hypercalcemia, subcutaneous fat necrosis, total parenteral nutrition administration, hyperthy- roidism, and adrenal insufficiency. Granulomatous disorders such as tuberculosis and sarcoidosis are rarer cause of hypercal- cemia. Hypercalcemia outcomes including nephrocalcinosis, brain, eye, artery calcifications and encephalopathic features are life-threatening. We report a seven-month-old girl with miliary tuberculosis who presented with severe hypercalcemia.

PDF

___

Diaz R. Calcium disorders in children and adolescents. In: Lifs- hitz F (ed). Pediatric Endocrinology Volume 2 . 5th ed. New York: Informa Halthcare USA Inc, 2007: 475-95.
Fisken RA, Heath DA, Somers S, Bold AM. Hypercalcaemia in hospital patients. Clinical and diagnostic aspects. Lancet 1981: 24; 202-7.
Rodd C, Goodyer P. Hypercalcemia of the newborn: etiology, evaluation, and management. Pediatr Nephrol 1999; 13: 542-7.
Diaz R. Abnormalities in calcium homeostasis. In: Radovick S, Mc Gillivroy MH (eds). Pediatric Endocrinology A Practical Guide. 1st ed. New Jersey: Humana Press, 2003: 344-63.
Parlar A, Kavaklı K. Williams syndrome (Elfin face syndrome). Ege Universitesi Tıp Fakültesi Dergisi 1990; 29: 471-3.
Sakallioglu O, Hacihamdioglu B, Balamtekin N, Kalman S, Gök F. Idiopathic infantile hypercalcemia and renal involve- ment. Int Urol Nephrol 2008; 40: 535-7.
Gerritsen J, Knol K. Hypercalcaemia in a child with miliary tu- berculosis. Eur J Pediatr 1989; 148: 650-1.
Okascharoen C, Nuntnarumit P, Sirinavin S. Neonatal tuber- culosis associated with shock, disseminated intravascular co- agulation, hemophagocytic syndrome, and hypercalcemia: a case report. J Perinatol 2003; 23: 79-81.
Sharma OP. Hypercalcemia in granulomatous disorders: a cli- nical review. Curr Opin Pulm Med 2000; 6: 442-7.
Kim JH, Langston AA, Gallis HA. Miliary tuberculosis: epide- miology, clinical manifestations, diagnosis, and outcome. Rev Infect Dis 1990; 12: 583-90.
Sbarbaro JA. Kochi’s tuberculosis strategy article is a “classic” by any definition. Bull World Health Organ 2001; 79: 71-5.
WHO. Global tuberculosis control: surveillance, planning, fi- nancing. Geneva: World Health Organization, 2006: 242.
Lönnroth K, Raviglione M. Global epidemiology of tuberculo- sis: prospects for control. Semin Respir Crit Care Med 2008; 29: 481-91.