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Case Conferences

   

October 23, 2013

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Total Posts: 16

Joined 2014-04-02

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What is your experience with hypercalcemia during TB treatment? Is this a component of IRIS in HIV-infected patients with disseminated TB after initiating ART? Does Vitamin D deficiency put a patient at increased risk for active TB? Is Vitamin D supplementation safe in TB Patients?  Hear the discussion and more!

     
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Total Posts: 21

Joined 2014-05-04

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This patient had a renal disease along with TB and Calcium metabolism is significantly affected under such situations making it important to be careful while supplemental Vit D and calcium supplementation.  If the hypercalcemia is asymptomatic do we treat it or just follow-up rather than vigorously treating it?

     
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Total Posts: 8

Joined 2014-05-30

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NAYANA - 13 June 2014 08:12 PM

This patient had a renal disease along with TB and Calcium metabolism is significantly affected under such situations making it important to be careful while supplemental Vit D and calcium supplementation.  If the hypercalcemia is asymptomatic do we treat it or just follow-up rather than vigorously treating it?

—While there is insufficient data to support one consensus approach, in cases of asymptomatic hypercalcemia, our preference is to hydrate vigorously and continue to treat the underlying disease.  We have seen improvements in these situations as the granulomatous disease is controlled.  We recommend discontinuing vit d or calcium supplementation in these settings.

     
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Total Posts: 21

Joined 2014-05-04

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Both cases were interesting. In developing countries vit D deficiency is very common in children and many times children are put on Vit D and calcium supplementation as a routine practice and the 2nd case highlights the importance of monitoring such patients to avoid Vit D toxicity.
We do not routinely do calcium estimation in children initiated on AKT . Also the AKI associated in the first case reinforces to monitor the kidney parameters for early detection of renal injury.