Severe metastatic calcifications in a hemodialysis patient

Labidi, J.; Ariba, Y. Ben; Gabsia, A. Ben; Ajili, F.; Battikh, R.; Louzir, B.; Abdelhafidh, N. Ben; Othman, Saleh I

doi:10.4103/1319-2442.190884

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…Soft-tissue calcifications in uremic patients can occur in several different anatomical locations, including arterial, ocular, subcutaneous, valvula, visceral, and periarticular [ 1 , 2 ]. It is postulated that this disease entity is associated with an increase calcium-phosphate-product and elevated PTH levels in ESRD patients.…”

Section: Discussionmentioning

confidence: 99%

“…Calcifications can arise rapidly within several months, such that negative radiological evaluations in the past medical history cannot reliably rule out de novo ectopic deposition of calcium deposits [ 4 ]. In extremely rare cases, ectopic tumoral calcinosis has been described in multiple distinct locations in the same patient [ 2 ] and concomitantly with calciphylaxis [ 5 ]. Nevertheless, in contrast to calciphylaxis, ectopic calcifications are not associated with warfarin therapy.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Cause of Left Shoulder Pain in a Peritoneal Dialysis Patient

2021

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Patient: Male, 46-year-old Final Diagnosis: Ectopic metastatic calcification Symptoms: Left shoulder pain Medication: — Clinical Procedure: Decrease serum phosphate levels Specialty: Nephrology • Orthopedics and Traumatology Objective: Unknown etiology Background: Non-specific pain of connective tissues and joints is one of the most frequently expressed patient concerns in everyday practice. The most common cause is osteo-degenerative changes in the cartilage and/or joint system. Metastatic calcification is a rare and initially often overlooked cause of persistent, therapy-resistant pain of connective tissues and joint apparatus in end-stage renal disease (ESRD) patients on dialysis therapy. These calcifications are induced by persistent hyperphosphatemia/hyperparathyroidism and can occur in various organs, including joints, tendons, heart valves, soft tissues, and blood vessels. Case Report: We report on a 46-year-old male patient with ESRD due to cANCA-associated systemic vasculitis. The patient evolved unfavorably to end-stage renal failure and started continuous ambulatory peritoneal dialysis (CAPD). Four years after initiation of CAPD, the patient reported having painful motion of the left shoulder, and symptomatic physiotherapy and non-steroidal-anti-inflammatory-drugs (NSAIDs) were prescribed. An X-ray examination of the left shoulder showed severe periarticular calcifications. Repeated nutritional counselling was offered, and intensive phosphate-binder therapy was administered, resulting in a reduction in phosphate levels from 2.10 mmol at the time of diagnosis to 1.26 mmol/l 16 months later. Radiological reevaluation showed a near complete resolution of the periarticular calcifications. Conclusions: Metastatic calcifications may arise in ESRD patients despite only moderately elevated blood phosphate levels. Intensive measures to reduce the phosphate load to normal levels should be implemented and can lead to almost complete resolution of ectopic calcifications in affected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Left Shoulder Pain in a Peritoneal Dialysis Patient

2021

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“…[ 4 ] Metastatic calcification can be detected using a CT scan or Technetium-99 m labeled bone scintigraphy. [ 5 6 ] Appropriate differentials for soft-tissue calcifications can be approached by the distribution patterns, additional laboratory testing and clinical findings.…”

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confidence: 99%

Extensive Metastatic Vascular Calcification in a Patient with Chronic Renal Failure and Tubercular Osteomyelitis as Seen on F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Damle

Prakash

Sethi

et al. 2023

Indian Journal of Nuclear Medicine

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A 48-year-old male with known tubercular osteomyelitis of the left elbow and chronic renal failure presented with PTH independent hypercalcemia and underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) to look for any underlying malignancy that might be causing his hypercalcemia. The PET/CT did not reveal any malignancy, but extensive metastatic calcification of small- and medium-sized arteries was noted throughout the body with relative sparing of large vessels. Alkaline tissue such as lungs, gastric mucosa, and kidneys that are usually involved in metastatic calcification were also spared. The underlying pathology for this kind of metastatic calcification was most likely chronic granulomatous disease, which was tubercular osteomyelitis in this patient. We present the PET/CT scan images of this unusual case of metastatic vascular calcification.

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Animal models of tendon calcification: Past, present, and future

Li,

Lai,

Luo

et al. 2024

Anim Models and Exp Med

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Tendon calcification is a common clinical condition that frequently occurs as a complication after tendon injury and surgery, or as an expression of fibrodysplasia ossificans progressiva. This condition can be referred to by various names in clinical practice and literature, including tendon ossification, tendon mineralization, heterotopic ossification, and calcific tendonitis. The exact pathogenesis of tendon calcification remains uncertain, but current mainstream research suggests that calcification is mostly cell mediated. To further elucidate the pathogenesis of tendon calcification and to better simulate the overall process, selecting appropriate experimental animal models is important. Numerous animal models have been utilized in various clinical studies, each with its own set of advantages and limitations. In this review, we have discussed the advancements made in research on animal models of tendon calcification, with a focus on the selection of experimental animals, the sites of injury in these models, and the methods employed for modeling.

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Severe metastatic calcifications in a hemodialysis patient

Cited by 5 publications

References 2 publications

A Rare Cause of Left Shoulder Pain in a Peritoneal Dialysis Patient

A Rare Cause of Left Shoulder Pain in a Peritoneal Dialysis Patient

Extensive Metastatic Vascular Calcification in a Patient with Chronic Renal Failure and Tubercular Osteomyelitis as Seen on F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Animal models of tendon calcification: Past, present, and future

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