Pulmonary Tuberculosis and Hypercalcaemia

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To the editor: Abbasi and associates (1) suggest that hypercalcemia associated with tuberculosis does not occur until 4 weeks after hospitalization and may be related to vitamin D intake. We have found that a disorder of calcium homeostasis is present at admission in many such patients and explain here why it is not usually recognized.

We have retrospectively studied 89 patients with culture-positive pulmonary tuberculosis admitted to the Royal Adelaide Hospital over a 2½-year period. Because hypoalbuminemia was present in 32 patients (36%) at admission, we corrected the calcium to the midpoint of the albumin reference range, assuming that 0.025

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