title: Hypercalcemia in a renal transplant recipient suffering with Pneumocystis carinii pneumonia.
abstract: Hypercalcemia occurs frequently after renal transplantation. Preexisting hyperparathyroidism is the most common cause of post-transplantation hypercalcemia. We describe a renal transplant recipient infected with Pneumocystis carinii pneumonia (PCP) who developed hypercalcemia, elevated 1,25-dihydroxyvitamin D, and suppressed parathyroid hormone levels. This phenomenon mimics the extrarenal production of 1,25-dihydroxyvitamin D by activated alveolar macrophages in granulomatous diseases with hypercalcemia. To the best of our knowledge, this is the first report of 1,25-dihydroxyvitamin D-mediated hypercalcemia caused by PCP in a renal transplant recipient. This entity should be included in the differential diagnosis for renal transplant recipients with hypercalcemia, especially in patients who develop lung infections.
authors.affiliation: Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Chen
authors.forename: Shi-Chuan
authors.initials: SC
authors.lastname: Chang
authors.forename: Tsai-Hung
authors.initials: TH
authors.lastname: Wu
authors.forename: Wu-Chang
authors.initials: WC
authors.lastname: Yang
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed