{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:52:08Z","timestamp":1767196328814,"version":"3.48.0"},"reference-count":9,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,14]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>\n                    Miliary tuberculosis (TB) is a rare but severe manifestation in infancy. Hypercalcaemia, well documented in granulomatous diseases like TB and sarcoidosis in adults, is infrequently reported in children. Nephrogenic diabetes insipidus induced by hypercalcaemia is a known complication. A female infant with right-sided neck swelling for 1\u2009month (fine-needle aspiration showed tubercular lymphadenitis), on four-drug anti-tubercular therapy (ATT), admitted with complaints of polyuria, polydipsia and progressive weight loss over the last 2\u2009weeks. Her father was on ATT for pulmonary TB. Investigations revealed hypercalcaemia with suppressed parathyroid hormone, elevated 25-hydroxyvitamin D\n                    <jats:sub>3<\/jats:sub>\n                    and 1,25-dihydroxyvitamin D\n                    <jats:sub>3<\/jats:sub>\n                    , high urinary calcium-to-creatinine ratio and dilute polyuria. Despite adequate hydration and ATT, hypercalcaemia persisted, necessitating corticosteroids, furosemide and a single dose of intravenous zoledronic acid. The child improved significantly with this approach. Hypercalcaemia in paediatric TB, although rare, can be a life-threatening emergency. Prompt recognition and multimodal treatment are crucial steps in management of the condition.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-269609","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:45:17Z","timestamp":1767195917000},"page":"e269609","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Miliary tuberculosis with hypercalcaemia-induced nephrogenic diabetes insipidus in an infant"],"prefix":"10.1136","volume":"18","author":[{"given":"Md","family":"Tousifullah","sequence":"first","affiliation":[{"name":"Paediatrics, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuj","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Paediatrics, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2025123107451366000_18.12.e269609.1","first-page":"411","article-title":"Successful management with bisphosphonate treatment in a child with tuberculosis-associated hypercalcemia","volume":"7","author":"K\u0131l\u0131n\u00e7","year":"2019","journal-title":"North Clin Istanbul"},{"key":"2025123107451366000_18.12.e269609.2","first-page":"613","article-title":"The prevalence of hypercalcaemia in pulmonary and miliary tuberculosis--a longitudinal study","volume":"35","author":"Chan","year":"1994","journal-title":"Singapore Med J"},{"key":"2025123107451366000_18.12.e269609.3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.5578\/tt.536","article-title":"Idiopathic infantile hypercalcemia or an extrapulmonary complication of tuberculosis?","volume":"61","author":"Yilmaz","year":"2013","journal-title":"Tuberk Toraks"},{"key":"2025123107451366000_18.12.e269609.4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1183\/09059180.00006910","article-title":"Symptomatic hypercalcaemia in paediatric tuberculosis","volume":"20","author":"Payne","year":"2011","journal-title":"Eur Respir Rev"},{"key":"2025123107451366000_18.12.e269609.5","doi-asserted-by":"crossref","first-page":"425","DOI":"10.11604\/pamj.2015.20.425.6542","article-title":"N\u00e9phrocalcinose compliquant une miliaire tuberculeuse chez un nourrisson","volume":"20","author":"Maghraoui","year":"2015","journal-title":"Pan Afr Med J"},{"key":"2025123107451366000_18.12.e269609.6","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2147\/PHMT.S435222","article-title":"Hypercalcemia in a 5-Year-Old Child with Disseminated Tuberculosis Case Report and Literature Review","volume":"14","author":"Salah","year":"2023","journal-title":"Pediatr Health Med Ther"},{"key":"2025123107451366000_18.12.e269609.7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/j.1440-1754.1978.tb02938.x","article-title":"Hypercalcaemia: An Unusual Complication of Tuberculosis. A Case Report","volume":"14","author":"Gaskin","year":"1978","journal-title":"J Paediatr Child Health"},{"key":"2025123107451366000_18.12.e269609.8","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1993.02160270032013"},{"key":"2025123107451366000_18.12.e269609.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.lab.2003.08.002"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269609","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:45:18Z","timestamp":1767195918000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":9,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,31]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-269609"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269609","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}