{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:42:55Z","timestamp":1753879375421,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Restrictive lung disease leading to abnormal lung function in kidney transplant recipients is commonly associated with noninfectious complications or medications used for post\u2010transplant immunosuppression. Herein, we report an interesting case of pediatric kidney transplant recipient with weight loss and abnormal spirometry who was diagnosed to have late\u2010onset <jats:italic>Pneumocystis<\/jats:italic> pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Report<\/jats:title><jats:p>A 17\u2010year\u2010old male patient with a history of allergic rhinitis, mild persistent asthma, and deceased donor kidney transplant, performed 18\u2009months prior, presented for routine evaluation of his asthma to the pulmonology clinic. He was clinically asymptomatic except for a weight loss of 8\u2009kg over 6\u2010month period prior to presentation. Patient's spirometry was suggestive of a restrictive pattern and further investigation using a high\u2010resolution computed tomography (HRCT) of the chest showed bilateral diffuse ground\u2010glass reticulonodular opacities with subpleural sparing suggestive of interstitial pneumonitis. A bronchoscopy with bronchoalveolar lavage revealed organisms consistent with <jats:italic>Pneumocystis jirovecii<\/jats:italic> on gomori\u2010methenamine\u2010silver (GMS) staining. Beta\u2010d\u2010glucan testing in serum revealed a level of &gt;500\u2009pg\/mL (normal 0\u201059\u2009pg\/mL) further supportive of <jats:italic>Pneumocystis jirovecii<\/jats:italic> infection. Patient was treated with a 6\u2010week course of trimethoprim\u2010sulfamethoxazole. His weight loss and beta\u2010d\u2010glucan levels improved over a course of 6\u2009months, and he continues to be on trimethoprim\u2010sulfamethoxazole prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Late\u2010onset <jats:italic>Pneumocystis jirovecii<\/jats:italic> infection in kidney transplant recipients can have an atypical presentation. Treating physicians should consider PJP in the differential diagnosis of unexplained weight loss in pediatric kidney transplant recipients, especially those receiving a large cumulative burden of immunosuppression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14576","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T06:56:19Z","timestamp":1689317779000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unique presentation of <scp>late\u2010onset<\/scp><i>Pneumocystis<\/i> pneumonia in a pediatric kidney transplant recipient"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6250-4704","authenticated-orcid":false,"given":"Manpreet","family":"Grewal","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Pediatrics Children's Hospital of Michigan  Detroit Michigan USA"},{"name":"Department of Pediatrics Central Michigan University College of Medicine  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruma","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Central Michigan University College of Medicine  Mount Pleasant Michigan USA"},{"name":"Division of Pulmonology, Department of Pediatrics Children's Hospital of Michigan  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn Y.","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Central Michigan University College of Medicine  Mount Pleasant Michigan USA"},{"name":"Division of Pediatric Infectious Diseases, Department of Pediatrics Children's Hospital of Michigan  Detroit Michigan USA"},{"name":"Department of Pediatrics Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein","family":"Salimnia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Central Michigan University College of Medicine  Mount Pleasant Michigan USA"},{"name":"Division of Microbiology Children's Hospital of Michigan  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrish","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Pediatrics Children's Hospital of Michigan  Detroit Michigan USA"},{"name":"Department of Pediatrics Central Michigan University College of Medicine  Mount Pleasant Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"49","volume-title":"Pulmonary Physiology","author":"Levitzy 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