Hypercalcemia and elevated 1,25(OH)2D3 levels in a dialysis patient with disseminated tuberculosis.

A 37-year-old diabetic patient with end-stage renal disease on maintenance dialysis developed widely disseminated tuberculosis. Tuberculosis was associated with hypercalcemia, inappropriately elevated serum levels of 1,25(OH)2D3, and consistently suppressed serum levels of iPTH. This case provides additional evidence that in granulomatous diseases extrarenal synthesis of 1,25(OH)2D3 may occur.