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Cataño JC, Aguirre HD, 2013. Disseminated paracoccidioidomycosis. Am J Trop Med Hyg 88: 407–408.
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Tresoldi AT, Periera RM, Castro LC, Rigatto SZ, Belangero VM, 2005. Hipercalcemia e lesões osteolíticas múltiplas em criança com paracoccidioidomicose disseminada e tuberculose pulmonar [Hypercalcemia and multiple osteolytic lesions in a child with disseminated paracoccidioidomycosis and pulmonary tuberculosis]. J Pediatr (Rio J) 81: 349–352.
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14.
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Silva LC, Ferrari TC, 1998. Hypercalcemia and paracoccidioidomycosis. Trans R Soc Trop Med Hyg 92: 187.
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Felsenfield AJ, Levine BS, 2006. Milk alkali syndrome and the dynamics of calcium homeostasis. Clin J A Soc Nephrol 1: 641–654.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 576 | 576 | 117 |
| Full Text Views | 28 | 28 | 13 |
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Hypercalcemia and Acute Kidney Injury Associated with Disseminated Paracoccidioidomycosis
Renan Gomes Mendes Diniz
renangomesdiniz@gmail.com
Renan Gomes Mendes Diniz
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Betina Nogueira Da Silva
Betina Nogueira Da Silva
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Raoni De Oliveira Domingues-Da-Silva
Raoni De Oliveira Domingues-Da-Silva
Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil
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Marcelo Arnone
Marcelo Arnone
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Walter Belda Júnior
Walter Belda Júnior
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Elizabeth De Francesco Daher
Elizabeth De Francesco Daher
Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil
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Lucia Andrade
Lucia Andrade
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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ABSTRACT.
Paracoccidioidomycosis is an acute to chronic systemic mycosis caused by the fungi Paracoccidioides. Hypercalcemia is a rare and not fully understood presentation of this infection. We present a case report of paracoccidioidomycosis associated with hypercalcemia and acute kidney injury (AKI) in an immunocompetent patient. An immunocompetent 30-year-old man from Brazil presented with papular erythematous-violaceous skin lesions, disseminated lymphadenopathy, pain in the left hypochondrium, fever with night sweats, and loss of 25 kilograms in 5 months. The result of a biopsy of the lesions was positive for Paracoccidioides brasiliensis. Laboratory findings were high total calcium and 1,25-dihydroxy vitamin D, with low parathyroid hormone, low albumin, and AKI. Computed tomography scans revealed splenic infarcts without bone lesions. Treatment was performed with methylprednisolone and liposomal amphotericin B. Calcium levels and kidney function normalized within 20 days of hospitalization. The patient was discharged 49 days after admission. A follow-up 6 months later revealed total clinical and serological remission.
Author Notes
Current contact information: Renan Gomes Mendes Diniz and Lucia Andrade, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mails: renangomesdiniz@gmail.com or drdiniznefrologisa@gmail.com and luciacan@usp.br. Betina Nogueira Da Silva, Marcelo Arnone, and Walter Belda Júnior, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mails: betina_nogueira@hotmail.com, arnones@uol.com.br, and walterbelda26@gmail.com. Raoni De Oliveira Domingues-Da-Silva and Elizabeth De Francesco Daher, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil, E-mails: domingues.raoni@gmail.com and ef.daher@uol.com.br.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Rivitti EA, 2018. Dermatologia de Sampaio e Rivitti. São Paulo, Brazil: Artes Médicas Editora.
-
2.
Marques SA, 2013. Paracoccidioidomycosis: Epidemiological, clinical, diagnostic and treatment up-dating. An Bras Dermatol 88: 700–711.
-
3.
Shikanai-Yasuda MA, et al., 2017. Brazilian guidelines for the clinical management of paracoccidioidomycosis. Rev Soc Bras Med Trop 50: 715–740. Erratum in: Rev Soc Bras Med Trop. 2017 Oct 16;0. Erratum in: Rev Soc Bras Med Trop. 2017 Nov–Dec;50(6):879–880.
-
4.
Basso SMM, Lumachi F, Nascimben F, Luisetto G, Camozzi V, 2012. Treatment of acute hypercalcemia. Med Chem 8: 564–568.
-
5.
Tonon CR, et al., 2022. A review of current clinical concepts in the pathophysiology, etiology, diagnosis, and management of hypercalcemia. Med Sci Monit 28: e935821.
-
6.
Chang WTW, Radin B, McCurdy MT, 2014. Calcium, magnesium, and phosphate abnormalities in the emergency department. Emerg Med Clin North Am 32: 344–366.
-
7.
Cataño JC, Aguirre HD, 2013. Disseminated paracoccidioidomycosis. Am J Trop Med Hyg 88: 407–408.
-
8.
Turner JJO, 2017. Hypercalcaemia – Presentation and management. Clin Med (Lond) 17: 270–277.
-
9.
Thillainadesan S, Twigg SM, Perera N, 2022. Prevalence, causes and associated mortality of hypercalcemia in modern hospital care. Intern Med J 52: 1596–1601.
-
10.
Khwaja A, 2012. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract 120: c179–c184.
-
11.
Kellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ, 2021. Acute kidney injury. Nat Rev Dis Primers 7: 52.
-
12.
Almeida RM, Cezana L, Tsukumo DM, de Carvalho-Filho MA, Saad MJ, 2008. Hypercalcemia in a patient with disseminated paracoccidioidomycosis. J Med Case Rep 2: 262.
-
13.
Tresoldi AT, Periera RM, Castro LC, Rigatto SZ, Belangero VM, 2005. Hipercalcemia e lesões osteolíticas múltiplas em criança com paracoccidioidomicose disseminada e tuberculose pulmonar [Hypercalcemia and multiple osteolytic lesions in a child with disseminated paracoccidioidomycosis and pulmonary tuberculosis]. J Pediatr (Rio J) 81: 349–352.
-
14.
Al-Majed SA, Sulimani R, Al-Kassimi F, Pandya L, Huraib S, Al-Sharif N, 1991. Hypercalcemia in active pulmonary tuberculosis. Ann Saudi Med 11: 289–292.
-
15.
Silva LC, Ferrari TC, 1998. Hypercalcemia and paracoccidioidomycosis. Trans R Soc Trop Med Hyg 92: 187.
-
16.
Riccardi D, Brown EM, 2010. Physiology and pathophysiology of the calcium-sensing receptor in the kidney. Am J Physiol Renal Physiol 298: F485–F499.
-
17.
Felsenfield AJ, Levine BS, 2006. Milk alkali syndrome and the dynamics of calcium homeostasis. Clin J A Soc Nephrol 1: 641–654.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 576 | 576 | 117 |
| Full Text Views | 28 | 28 | 13 |
| PDF Downloads | 43 | 43 | 20 |