Pneumocystis jirovecii pneumonitis: cause of acute hypercalcaemia in chronic haemodialysis patient.
BMJ Case Rep
; 13(1)2020 Jan 26.
Article
em En
| MEDLINE
| ID: mdl-31988055
ABSTRACT
A 76-year-old renal transplant patient due to autosomal dominant polycystic kidney disease who resumed chronic haemodialysis was admitted to our hospital for confusion and lassitude. He was afebrile and physical examination revealed diffuse bilateral rales with decreased respiratory sounds in lower right lung. Laboratory data showed hypercalcaemia (total calcium 3.92 mmol/L (normal range 2.2-2.6 mmol/L), ionised calcium 1.87 mmol/L (1.15-1.35 mmol/L)), low intact parathyroid hormone (iPTH) 15 ng/L, (15-65 ng/L) and high 1,25(OH)2D3 128.9 pg/mL, (15.2-90.1 pg/mL). Chest CT-scan revealed bilateral apical lung lesions after 15 days of antibiotics. Bronchoalveolar sample was PCR positive for Pneumocystis jirovecii He was treated with an extra session of haemodialysis with 1.25 mmol/L dialysate calcium concentration, oral trimethoprim-sulfamethoxazole was started and oral corticosteroid dose increased to 1 mg/kg for 1 week. Hypercalcaemia decreased progressively after initiation of these treatments. We concluded a case of hypercalcaemia secondary to P. jirovecii infection.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Pneumonia por Pneumocystis
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Rim Policístico Autossômico Dominante
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Hipercalcemia
Limite:
Aged
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Humans
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Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article