Hypercalcaemia in patients with newly diagnosed tuberculosis in Malaysia

SETTING: University Hospital, Kuala Lumpur, Malaysia. OBJECTIVE: To determine the incidence of hypercalcaemia in Malaysian patients with newly diagnosed tuberculosis (TB) before the commencement of antituberculosis treatment. DESIGN: A prospective study of consecutive patients with newly diagnosed bacteriologically and/or histologically proven tuberculosis in our institution from September 1994 to March 1996. RESULTS: Of a total of 120 patients (67 males, 53 females), 68 had pulmonary TB, nine had pulmonary and pleural TB, 18 had pleural TB without chest radiograph evidence of lung involvement, 16 had various other forms of extra-pulmonary TB and nine had disseminated TB. The mean age of the patients was 44.3 (+/-18.0) years. The mean albumin-adjusted serum calcium concentration was 2.53 (+/-0.22) mmol/l. Hypercalcaemia was present in 27.5% of the patients, but only 12% of these patients showed symptoms of hypercalcaemia. The type of TB and, in the case of pulmonary TB, the radiographic extent of lung involvement, had no effect on the serum calcium level. CONCLUSION: Hypercalcaemia is not uncommon among Malaysian patients with newly diagnosed TB, but it is rarely symptomatic.