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The prevalence and significance of hypercalcemia in PJP remain unclear, especially in kidney transplant recipients (KTR) who frequently display hypercalcemia <jats:italic>via<\/jats:italic> persisting hyperparathyroidism. We here retrospectively identified all microbiologically-proven PJP in adult KTR from 2005 to 2017 in the Lille University Hospital, and studied the mineral and bone metabolism parameters during the peri-infectious period. Clinical features of PJP-patients were analyzed according to their serum calcium level. Hypercalcemia (12.6\u2009\u00b1\u20091.6\u2009mg\/dl) was observed in 37% (18\/49) of PJP-patients and regressed concomitantly to specific anti-infectious treatment in all cases. No other cause of hypercalcemia was identified. In hypercalcemic patients, serum levels of 1,25-dihydroxyvitamin D were high at the time of PJP-diagnosis and decreased after anti-infectious treatment (124\u2009\u00b1\u200962 <jats:italic>versus<\/jats:italic> 28\u2009\u00b1\u200923\u2009pg\/mL, <jats:italic>p<\/jats:italic>\u2009=\u2009<jats:italic>0.006<\/jats:italic>) while PTH serum levels followed an inverse curve (35\u2009\u00b1\u200934 <jats:italic>versus<\/jats:italic> 137\u2009\u00b1\u200999\u2009pg\/mL, <jats:italic>p<\/jats:italic>\u2009=\u2009<jats:italic>0.009<\/jats:italic>), suggesting together a granuloma-mediated mechanism. Febrile dyspnea was less frequent in hypercalcemic PJP-patients compared to non-hypercalcemic (29 <jats:italic>versus<\/jats:italic> 67%). In summary, hypercalcemia seems common during PJP in KTR. Unexplained hypercalcemia could thus lead to specific investigations in this particular population, even in the absence of infectious or respiratory symptoms.<\/jats:p>","DOI":"10.1038\/s41598-019-49036-w","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T10:03:26Z","timestamp":1567073006000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Hypercalcemia is common during Pneumocystis pneumonia in kidney transplant recipients"],"prefix":"10.1038","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4988-206X","authenticated-orcid":false,"given":"Aghil\u00e8s","family":"Hamroun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9mi","family":"Lenain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linh","family":"Bui Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Chamley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9verine","family":"Loridant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Neugebauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Lionet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Frimat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Hazzan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"49036_CR1","doi-asserted-by":"publisher","first-page":"2487","DOI":"10.1056\/NEJMra032588","volume":"350","author":"CF Thomas Jr.","year":"2004","unstructured":"Thomas, C. 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