Metastatic pulmonary calcification in chronic renal failure

Madhusudhan, Kumble Seetharama; Shad, Pratibha S.; Sharma, Sumat; Goel, Ashwini; Mahajan, Harsh

doi:10.1007/s11255-011-0035-6

Cited by 15 publications

(30 citation statements)

References 11 publications

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“…Previous case reports of PC in patients on dialysis not receiving STS highlighted the potentially life-threatening nature of this medical condition, which frequently causes chronic respiratory failure or death. 15 – 18 Cadavid et al 19 described 1 patient with metastatic calfication and skin lesions suggestive of calciphylaxis in whom parenchymal infiltration was not significantly improved by STS and cinacalcet treatment. Nevertheless, the diagnosis of calciphylaxis in this patient was suspected on clinical grounds but not confirmed by biopsy, and no information was provided about the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Lung Calciphylaxis With Sodium Thiosulfate in a Patient With Sickle Cell Disease

et al. 2016

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Calciphylaxis is a small vessel vasculopathy, characterized by medial wall calcification that develops in a few patients with chronic renal failure. The prognosis of skin calciphylaxis has improved considerably since the introduction of sodium thiosulfate (STS), but it remains unclear whether this therapy is effective against organ lesions related to calciphylaxis. Pulmonary calciphylaxis is a usually fatal medical condition that may occur in association with skin involvement in patients with end-stage renal disease.We report here the case of a 49-year-old woman homozygous sickle cell disease patient on chronic hemodialysis with biopsy-proven systemic calciphylaxis involving the lungs and skin. On admission, ulcerative skin lesions on the lower limbs and bilateral pulmonary infiltrates on chest computerized tomography scan were the main clinical and radiological findings. Skin and bronchial biopsies demonstrated calciphylaxis lesions. The intravenous administration of STS in association with cinacalcet for 8 consecutive months led to a clear improvement in skin lesions and thoracic lesions on chest computerized tomography scan.This case suggests for the first time that organ lesions related to calciphylaxis, and particularly lung injury, are potentially reversible. This improvement probably resulted from the combination of 3 interventions (more frequent dialysis, cinacalcet, and STS), rather than the administration of STS alone.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Lung Calciphylaxis With Sodium Thiosulfate in a Patient With Sickle Cell Disease

et al. 2016

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“…La causa más común de CPM es la IRC, tanto en etapa pre-dialítica como dialítica 3,8,10,15,16,25 . Algunos pacientes afectados tienen hipercalcemia, hiperfosfemia y una concentración de paratohormona elevada con producto calcio/fósforo>70 en forma persistente 7,9,[15][16][17]21,24,27 , sin embargo, otros no presentan estos trastornos 9,11,12,24 . Aparentemente no existe una correlación entre la duración de la terapia dialítica y la CPM, aunque esto ha sido controvertido 12,28 .…”

Section: Discussionunclassified

“…La TCAR habitualmente muestra opacidades nodulares centrolobulares de 3-10 mm de diámetro en forma difusa, situadas hasta 1 cm del margen pleural con indemnidad de las regiones costofrénicas. Las calcificaciones pueden ser puntiformes o en anillo envolviendo completamente al nódulo 3,8,11,16,19 . También pueden observarse aéreas de vidrio esmerilado o consolidación pulmonar con distribución lobar 3,9,16,17,19 .…”

Section: Discussionunclassified

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Calcificaciones pulmonares metastásicas en un trasplantado renal con un injerto con función renal adecuada: Caso clínico

Vega

Goecke

Valenzuela³

et al. 2013

Rev. méd. Chile

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. Estas últimas son frecuentes en pacientes con IRC en HD, aunque muy rara vez se diagnostican en vida [6][7][8][9][10][11][12] . Las radiografías de tórax tienen una escasa sensibilidad para detectarlas 10,12,17 . En autopsias de pacientes con IRC en HD se encuentran calcificaciones pulmonares metastásicas (CPM) en 60-75% de ellos 13 . La evolución clínica de las CPM habitualmente es benigna y a menudo asintomática. Otras veces existe tos no productiva y disnea de esfuerzo, ocasionalmente puede seguir un curso fulminante y fatal 9,14,17 o asociarse a calcifilaxis y necrosis pulmonar 18 . Las CPM se han observado también en pacientes con hiperparatiroidismo primario y secundario, hipercalcemias de otras causas, terapia endovenosa con calcio, mieloma múltiple, leucemias, sarcoidosis, intoxicación por vitamina D, osteolisis masiva por metástasis, síndrome de leche-alcalinos, enfermedad de Paget , neoplasia endocrina múltiple 9,19-21 y en trasplantados renales (TxR) con injertos disfuncionantes 4,7,14,16,17,22,23 . Rara vez se ha observado CPM en pacientes con trasplantes exitosos 8,24,25 . Comunicamos un caso de CPM diagnosticada en un paciente trasplantado renal 19 años atrás con una buena función del injerto.

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“…[ 3 ] Other less common complications include pulmonary hypertension,[ 4 ] pulmonary fibrosis. [ 5 ] and pulmonary calcifications[ 6 ] [ Table 1 ]. It is important to identify these patients and make sure that they are treated more aggressively as postoperative pulmonary complications in non-thoracic surgery patients have been seen in 2-19% of patients.…”

Section: Introductionmentioning

confidence: 99%

Presurgical pulmonary evaluation in renal transplant patients

et al. 2014

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Patients with chronic renal failure (CRF) due to various mechanisms are prone to significant pulmonary comorbidities. With the improvements in renal replacement therapy (RRT), patients with CRF are now expected to live longer, and thus may develop complications in the lung from these processes. The preferred treatment of CRF is kidney transplantation and patients who are selected to undergo transplant must have a thorough preoperative pulmonary evaluation to assess pulmonary status and to determine risk of postoperative pulmonary complications. A MEDLINE®/PubMed® search was performed to identify all articles outlining the course of pre-surgical pulmonary evaluation with an emphasis on patients with CRF who have been selected for renal transplant. Literature review concluded that in addition to generic pre-surgical evaluation, renal transplant patients must also undergo a full cardiopulmonary and sleep evaluation to investigate possible existing pulmonary pathologies. Presence of any risk factor should then be aggressively managed or treated prior to surgery.

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Metastatic pulmonary calcification in chronic renal failure

Cited by 15 publications

References 11 publications

Successful Treatment of Lung Calciphylaxis With Sodium Thiosulfate in a Patient With Sickle Cell Disease

Successful Treatment of Lung Calciphylaxis With Sodium Thiosulfate in a Patient With Sickle Cell Disease

Calcificaciones pulmonares metastásicas en un trasplantado renal con un injerto con función renal adecuada: Caso clínico

Presurgical pulmonary evaluation in renal transplant patients

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