Hypercalcemia in a renal transplant recipient suffering with Pneumocystis carinii pneumonia.
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.
Chen
Wen-Chin
WC
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Chang
Shi-Chuan
SC
Wu
Tsai-Hung
TH
Yang
Wu-Chang
WC
Tarng
Der-Cherng
DC
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