{
  "abstract": "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 month (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 weeks. Her father was on ATT for pulmonary TB. Investigations revealed hypercalcaemia with suppressed parathyroid hormone, elevated 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3, 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.",
  "authors": [
    {
      "affiliations": [
        "Paediatrics, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India"
      ],
      "name": "Md Tousifullah"
    },
    {
      "affiliations": [
        "Paediatrics, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India"
      ],
      "name": "Anuj Rastogi"
    }
  ],
  "title": "Miliary tuberculosis with hypercalcaemia-induced nephrogenic diabetes insipidus in an infant",
  "uid": "a3dfc580-965c-55af-a2e4-f6439c74d5f3"
}