{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:33:48Z","timestamp":1761824028499,"version":"3.44.0"},"reference-count":24,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,12,2]]},"abstract":"<jats:p>Hypercalcaemia occurs in many granulomatous diseases. Among them, sarcoidosis and tuberculosis are the most common causes. Other causes include berylliosis, coccidioidomycosis, histoplasmosis, Crohn\u2019s disease, silicone-induced granulomas, cat-scratch disease, Wegener\u2019s granulomatosis and <jats:italic>Pneumocystis carinii<\/jats:italic> pneumonia. Hypercalcaemia in granulomatous disease occurs as a consequence of dysregulated production of 1,25-(OH)2 D3 (calcitriol) by activated macrophages in granulomas. Hypercalcaemia in patients with <jats:italic>Mycobacterium tuberculosis<\/jats:italic> infection has been reported in 0%\u201328% of cases. Uncultured bronchoalveolar lavage cells from patients with <jats:italic>M. tuberculosis<\/jats:italic> produce greater amounts of calcitriol compared with controls. Although Nayar <jats:italic>et al<\/jats:italic> described hypercalcaemia in a case of sepsis associated with intravesical Bacille Calmette Guerin therapy, there are no published reports describing hypercalcaemia in patients with pulmonary <jats:italic>M. bovis<\/jats:italic> infection. We describe a patient with <jats:italic>M. bovis<\/jats:italic> cavitary pulmonary infection with sustained hypercalcaemia that fluctuated and recurred repeatedly over the course of therapy, ultimately culminating in normalisation of serum calcium when therapy had led to cure. Treatment consisted of antituberculous therapy, oral corticosteroids and intravenous bisphosphonates with a favourable outcome.<\/jats:p>","DOI":"10.1136\/bcr-2017-222351","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T22:45:20Z","timestamp":1517006720000},"page":"bcr-2017-222351","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Fluctuating hypercalcaemia caused by cavitary <i>Mycobacterium bovis<\/i> pulmonary infection"],"prefix":"10.1136","volume":"2018","author":[{"given":"Darren Patrick","family":"Moloney","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Mercy University Hospital, Cork, Munster, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Chawke","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mercy University Hospital, Cork, Munster, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mairead Therese","family":"Crowley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mercy Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terence M","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mercy University Hospital, Cork, Munster, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,26]]},"reference":[{"key":"2025082703534240000_2018.jan26_1.bcr-2017-222351.1","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/S0889-8529(18)30365-7","article-title":"Vitamin D metabolite-mediated hypercalcemia","volume":"18","author":"Adams","year":"1989","journal-title":"Endocrinol Metab Clin North 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