Denosumab in a pediatric kidney transplant recipient with late, resistant hypercalcemia secondary to Pneumocystis jirovecii pneumonia.

Autor: Beale F; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom., Gkiourtzis N; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.; 4th Pediatric Department AUTH, 'Papageorgiou' General Hospital, Thessaloniki, Greece., Koneru S; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom., O'Brien C; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom., Lalayiannis AD; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom. alex.lalayiannis@nhs.net.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Aug; Vol. 39 (8), pp. 2355-2358. Date of Electronic Publication: 2024 Jan 26.
DOI: 10.1007/s00467-024-06288-7
Abstrakt: Kidney transplant recipients (KTR) are at an increased risk of developing Pneumocystis jirovecii pneumonia (PCP), especially during the first year after transplantation. This is the first reported pediatric KTR, with chronic kidney disease (CKD) secondary to kidney dysplasia and vesicoureteral reflux, who developed refractory and symptomatic hypercalcemia 5 years after transplantation. The hypercalcemia was resistant to treatment with intravenous hyperhydration, furosemide, and a low-calcium diet. A respiratory tract infection due to PCP treated with trimethoprim-sulfamethoxazole did not improve calcium levels. Due to the hypercalcemic symptom burden for the patient, a single dose of subcutaneous denosumab was used to achieve sustained clinical and biochemical improvement, without any severe adverse events. This case highlights the potential use of denosumab as a treatment option in pediatric KTR with refractory hypercalcemia related to PCP. Further study of denosumab in young people with CKD or kidney transplants is needed before routine use can be recommended.
(© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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