An interesting case of aches and pains

We report a case who presented with all symptoms of hypercalcemia. Initially hypercalcemia seemed to be iatrogenic secondary to hypervitaminosis D, but she did not respond to steroids. Symptoms and high levels vit D and calcium persisted and clinically her condition was worsening which made us to explore other causes of hypercalcemia. Biopsy of skeletal lesion found on PET scan reviled skeletal tuberculosis which was responsible for ectopic production of vit D leading to hypercalcemia. Rare but not uncommon cause of hypercalcemia.