Document Detail


Hypercalcemia after transplant nephrectomy in a hemodialysis patient: a case report.
MedLine Citation:
PMID:  18053167     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Hypercalcemia is a complication often seen in chronic hemodialysis patients. A rare cause of this condition is sarcoidosis. Its highly variable clinical presentation is challenging. Especially in patients suffering chronic kidney graft failure the nonspecific constitutional symptoms of sarcoidosis like fever, weight loss, arthralgia and fatigue may be easily misleading.
CASE PRESENTATION: A 51 year old male developed hypercalcemia, arthralgia and B-symptoms after explantation of his kidney graft because of suspected acute rejection. The removed kidney showed vasculopathy and tubulointerstitial nephritis, which had not been overt in the biopsy taken half a year earlier. Despite explantation and withdrawal of the immunosuppression the patient's general condition deteriorated progressively. A rapid rise in serum calcium finally provoked us to check for sarcoidosis. CT scans of the lungs, broncho-alveolar-lavage and further lab tests confirmed the diagnosis.
CONCLUSION: This case demonstrates that withdrawal of immunosuppressive drugs sometimes unmasks sarcoidosis. It should be considered as differential diagnosis even in hemodialysis patients, in whom other reasons for hypercalcemia are much more common.
Authors:
Ivo Quack; Magdalena Woznowski; Gisela Schieren; Stefan M Weiner; Guido Winnekendonk; Faruk Tokmak; Lars C Rump; Dirk Rattensperger
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Publication Detail:
Type:  Journal Article     Date:  2007-12-03
Journal Detail:
Title:  Journal of medical case reports     Volume:  1     ISSN:  1752-1947     ISO Abbreviation:  J Med Case Rep     Publication Date:  2007  
Date Detail:
Created Date:  2008-02-13     Completed Date:  2011-07-14     Revised Date:  2012-05-16    
Medline Journal Info:
Nlm Unique ID:  101293382     Medline TA:  J Med Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  164     Citation Subset:  -    
Affiliation:
Kuratorium für Heimdialyse und Nierentransplantation, Cruismannstrasse 37, 44807 Bochum, Germany. Dirk.Rattensperger@kfh-dialyse.de.
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