A case of hypercalcemia with hyperparathyroidsm on severe immunodeficiency stage 4 HIV infection, lung tuberculous infection, protein energy malnutrition treated with zolendronic acid

Introduction: Hypercalcemia referred as serum calcium level over two standard deviations above the average mean values. Clinical manifestations may be due to hypercalcemia or may be due to the causal disorder or may be due to both. Hypercalcemia disorders can caused by group of illness/abnormalities.

Cases Presentation: A-5 year-4 months old girl was taken to hospital with chief complaint fatigue and shortness of breath. Patient was also complained decrease of appetite since 6 months before hospital admission. Patient was diagnosed with Human Immunodeficiency Virus (HIV) infection and lung tuberculosis infection. On serial laboratory examination found hypercalsemia and increase of septic marker, increase of parathyroid hormone on normal vitamin D level. Patient showed rapid clinical improvement on the second day after administration of zolendronic acid. Antibiotics, Oral Antituberculosis Treatment (OAT) and supportive treatment were administrated due to comorbidities.

Summary: Hypercalcemia is a rare conditions in children with HIV infections. Zolendronic acid should be considered for patient with hypercalcemia.