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Hypercalcaemia as a prodromal feature of indolent Pneumocystis jivorecii after renal transplantation


Following renal transplantation, hypercalcaemia is frequently caused by persisting hyperparathyroidism. Unregulated extrarenal 1,25-dihydroxyvitamin D (1,25(OH)(2)D) synthesis, which is well recognized as a cause of hypercalcaemia in granulomatous diseases, may also occur after kidney transplantation. This mechanism is also likely to be responsible for hypercalcaemia reported during treatment of cytomegalovirus and associated with acute symptomatic pneumocystis jivorecii pneumonia (PCP). Hypercalcaemia as a prodromal feature of indolent PCP has not been described. We report a renal transplant recipient who developed hypercalcaemia 30 months post-transplant due to extrarenal production of 1,25(OH)(2)D. Two months later, PCP was diagnosed and hypercalcaemia resolved after initiation of treatment.

Type Journal
ISBN 1460-2385 (Electronic) 0931-0509 (Linking)
Authors Bency, R.; Roger, S. D.; Elder, G. J.;
Responsible Garvan Author Prof Grahame Elder
Published Date 2011-01-01
Published Volume 26
Published Issue 5
Published Pages 1740-2
Status Published in-print
URL link to publisher's version
OpenAccess link to author's accepted manuscript version