Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPRAMALHO, J.MARQUES, I. D. BacelarAGUIRRE, A. R.PIERROTTI, L. C.PAULA, F. J. deNAHAS, W. C.DAVID-NETO, E.2014-09-302014-09-302014TRANSPLANT INFECTIOUS DISEASE, v.16, n.2, p.315-319, 20141398-2273https://observatorio.fm.usp.br/handle/OPI/7310Pneumocystis jirovecii pneumonia (PCP) continues to be a leading cause of morbidity and mortality in kidney transplant recipients. Granulomatous PCP is an unusual histological presentation that has been described in a variety of immunosuppressive conditions. Previous studies have demonstrated an association between granulomatous disorders and hypercalcemia, the purported mechanism of which is extrarenal production of 1,25-dihydroxyvitamin D by activated macrophages. Here, we report a case of granulomatous formation in a kidney transplant recipient with PCP who presented with hypercalcemia and suppressed parathyroid hormone, both of which resolved after successful treatment of the pneumonia. In immunocompromised patients, pulmonary infection associated with hypercalcemia should raise the suspicion of PCP and other granulomatous disorders.engrestrictedAccesshypercalcemiaPneumocystis jiroveciigranulomakidney transplantationcarinii-pneumoniavitamin-drenal-transplantationhypercalcemiapatientsarcoidosisaidshivarticleCopyright WILEY-BLACKWELL10.1111/tid.12198ImmunologyInfectious DiseasesTransplantation1399-3062