A case of Pneumocystis pneumonia, with a granulomatous response and vitamin D‐mediated hypercalcemia, presenting 13 years after renal transplantation

Abstract

Vitamin D‐mediated hypercalcemia is an uncommon complication of Pneumocystis infection. A granulomatous response resulting from Pneumocystis infection is also atypical. In this report, we describe an exceptional case of granulomatous Pneumocystis pneumonia associated with vitamin D‐mediated hypercalcemia, in a patient who presented unusually late after renal transplantation. The patient's hypercalcemia resolved with treatment of the infection.

Late-Onset Granulomatous Pneumocystis jirovecii Pneumonia in A Renal Transplant Recipient: A Clinical Grand Round Conference Case in 2022

“…According to a study of PCP cases among kidney transplant recipients, hypercalcemia was observed in 37% of PCP patients with high 1,25-(OH) 2 vitamin D and low parathyroid hormone (PTH), suggesting a granuloma-mediated mechanism [ 30 ]. This resolved after successful treatment of PCP pneumonia [ 31 ]. Hypercalcemia has also been reported in patients with PCP infection who have undergone liver transplant or have AIDS [ 32 33 ].…”