title: Hypercalcemia and suppressed PTH levels in a renal transplant patient infected with Pneumocystis carinii.
abstract: Pneumocystis carinii pneumonia is a serious and relatively common complication of immunosuppressive therapy. In immunocompromised patients, P. carinii pneumonia can cause significant morbidity and mortality. Another common complication, typically seen in the subpopulation of renal transplant recipients, is hypercalcemia. The prevalence of hypercalcemia varies, reaching as high as 71%. We report the case of a renal transplant recipient who developed P. carinii pneumonia and hypercalcemia, the latter being resolved after the successful treatment of the former. We argue that there is a causal relationship between P. carinii pneumonia and hypercalcemia in renal transplant recipients. In immunocompromised patients, pulmonary infection accompanied by hypercalcemia should raise the suspicion of P. carinii pneumonia.
authors.affiliation: Intensive Care Unit, Nephrology Department, University of São Paulo School of Medicine, São Paulo, Brazil. annarita77@yahoo.com
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Aguirre
authors.forename: Bruno Eduardo Pedroso
authors.initials: BE
authors.lastname: Balbo
authors.forename: Luiz Estevam
authors.initials: LE
authors.lastname: Ianhez
authors.forename: Maristela Carvalho
authors.initials: MC
authors.lastname: da Costa
authors.forename: Lúcia
authors.initials: L
authors.lastname: Andrade
mesh_terms: D002117:Calcitriol / Q000097:blood; D015984:Causality; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011020:Pneumonia, Pneumocystis / Q000097:blood / Q000150:complications*
chemical_list: D010281:Parathyroid Hormone; D002117:Calcitriol