COCCIDIOIDOMYCOSIS-INDUCED THYROIDITIS AND CALCITRIOL-MEDIATED HYPERCALCEMIA IN A HEART-TRANSPLANTATION PATIENT

A 56-year-old man with a history of cardiac transplantation developed disseminated coccidioidomycosis involving the upper extremities, Suppr ession of thyrotropin was followed by marked biochemical hypothyroidis m. Biopsy of an enlarged left thyroid lobe demonstrated infiltration w ith coccidioidomycosis, He also developed hypercalcemia thought to be mediated by 1,25-dihydroxyvitamin D and was treated with a bisphosphon ate. This rare case of disordered calcium metabolism and thyroiditis s hould alert physicians of the potential endocrinopathies that can deve lop in patients who have undergone solid organ transplantation.