Hypercalcemia in Coccidioidomycosis

To the Editor: I take issue with the conclusion of Lee and his colleagues¹ that the mechanism of hypercalcemia in three patients with disseminated coccidioidomycosis “appears to be independent of parathyroid hormone.” They state that two of these patients had “normal” plasma parathyroid levels, and one had normal parathyroid glands on post-mortem examination after approximately four months of almost sustained hypercalcemia. In normal man, secretion of parathyroid hormone is influenced by ionized calcium through a negative feedback mechanism, and hypercalcemia from causes unrelated to parathyroid hormone is usually associated with undetectable hormone in the plasma.² Therefore, it is conceivable that. No extract is available for articles shorter than 400 words.