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Titolo:
Hypercalcemia associated with infection by Cryptococcus neoformans and Coccidioides immitis
Autore:
Ali, MY; Gopal, KV; Llerena, LA; Taylor, HC;
Indirizzi:
Case Western Reserve Univ, Sch Med, Div Infect Dis & Endocrinol, Fairview Gen Hosp,Cleveland Clin Hlth Syst, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA Case Western Reserve Univ, Sch Med, Dept Clin & Mol Endocrinol, Cleveland,OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 , Cleveland,OH 44106 USA
Titolo Testata:
AMERICAN JOURNAL OF THE MEDICAL SCIENCES
fascicolo: 6, volume: 318, anno: 1999,
pagine: 419 - 423
SICI:
0002-9629(199912)318:6<419:HAWIBC>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNODEFICIENCY-VIRUS INFECTION; KETOCONAZOLE-INDUCED REDUCTION; VITAMIN-D; 1,25-DIHYDROXYVITAMIN-D LEVELS; SERUM 1,25-DIHYDROXYVITAMIN-D; MEDIATED HYPERCALCEMIA; WEGENER GRANULOMATOSIS; LIPOID PNEUMONIA; CALCIUM; SARCOIDOSIS;
Keywords:
hypercalcemia; HIV; Cryptococcus neoformans; Coccidioides immitis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Taylor, HC Lutheran Hosp, 1730 W 25th St, Cleveland, OH 44113 USA LutheranHosp 1730 W 25th St Cleveland OH USA 44113 H 44113 USA
Citazione:
M.Y. Ali et al., "Hypercalcemia associated with infection by Cryptococcus neoformans and Coccidioides immitis", AM J MED SC, 318(6), 1999, pp. 419-423

Abstract

Background: Of the 13 reported cases of hypercalcemia associated with fungal infection, 1 was caused by Cryptococcus neoformans and probably mediatedby increased levels of 1,25-dihydroxyvitamin D [1,25(OH)(2)D]. Eight others were associated with Coccidioides immitis, of which only 2 had measured 1,25(OH),D levels; in both, they were diminished. We report a patient with human immunodeficiency virus infection and simultaneous C immitis and C neoformans pneumonia and C immitis fungemia associated with hypercalcemia. Methods: Consecutive measurements of serum total and ionized calcium, phosphorous, blood urea nitrogen, creatinine, 25(OH)DI 1,25(OH),D, parathyroid hormone (PTH), parathyroid hormone-related protein (PTHrp) and albumin were performed over a period of 46 months. Results: While the patient was hypercalcemic, intact serum PTH and PTHrp were undetectable, serum 25(OH)D levels were normal, and serum 1,25(OH)(2)D levels were in the high normal range. Successful treatment of the C immitis and C neoformans infections resulted in resolution of the hypercalcemia and increase of PTH and PTHrp to the normal range. Conclusion: In some patients with HIV infection, coincident hypercalcemia, and severe fungal infection, the responsible factor may be 1,25(OH)(2)D. Although total serum levels of this compound may not be frankly elevated, they are inappropriately high for the circumstances. Free 1,25(OH)(2)D levels should be determined in this situation.

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Documento generato il 27/09/20 alle ore 00:55:31