title: Hypercalcemia in a male-to-female transgender patient after body contouring injections: a case report.
abstract: BACKGROUND
  Body contouring injections by non-licensed providers are frequently sought out by a subset of the male-to-female transgender community. Although short-term side effects such as pulmonary embolism and injection site infection are well known, long-term consequences of such practices are less well studied.
  
  
  METHODS
  Here we describe the case of a 40-year-old African American male-to-female transgender patient who presented to our institution with hypercalcemia and acute renal failure secondary to body contouring injections with industrial strength silicone by non-licensed providers, a decade prior to her visit. Work-up revealed an extensive granulomatous inflammatory process in the injection area resulting in electrolyte abnormalities and kidney injury. The patient's lab results and symptoms responded well to long-term corticosteroid treatment and correlated with treatment adherence.
  
  
  CONCLUSIONS
  Affected patients can sometimes present with unusual clinical symptoms many years after silicone injections. In a constantly growing transgender community that often utilizes non-licensed providers for silicone injections, the medical community will likely face an increasing number of patients with long-term side effects of such practices. Therefore, it is imperative for physicians to recognize such cases promptly and initiate potentially life-saving treatment.
authors.affiliation: Department of Internal Medicine, Beth Israel Medical Center, Albert Einstein College of Medicine, 1st Ave at 17th St, Baird Hall, 20th Floor, New York, NY 1000, USA. koppanyvisnyei@gmail.com.
authors.forename: Koppany
authors.initials: K
authors.lastname: Visnyei
authors.forename: Maria
authors.initials: M
authors.lastname: Samuel
authors.forename: Laura
authors.initials: L
authors.lastname: Heacock
authors.forename: Jose A
authors.initials: JA
authors.lastname: Cortes