Nebulized Pentamidine-Induced Acute Renal Allograft Dysfunction

Acute kidney injury (AKI) is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allograft dysfunction due to nebulised pentamidine. The patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Graft function stabilised following discontinuation of the drug. This is the first report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allograft. This diagnosis should be considered in a case of unexplained acute renal allograft dysfunction

An Unusual Presentation of Giant Cell Arteritis

Giant cell arteritis (GCA) is a chronic vasculitis that typically presents with headache, fever and polymyalgia although atypical presentations are known. We present a case of GCA with nonproductive cough and pyrexia of unknown origin emphasizing this atypical nature of presentation. We report a rare association of GCA with granulomatous hepatitis. We also support the use of PET scanning in diagnosing and monitoring this condition

An unusual Cause of Periorbital Swelling in a Young Female

A 16 year old female was admitted with a one week history of headache and swelling of both upper eyelids. Other symptoms included nausea, tiredness, dizziness and photophobia with no symptoms of skin rash, or neck stiffness. She had been previously very well with no significant past medical history.</jats:p