Progressive Tumoral Calcinosis in a Haemodialysis Patient Despite Medical and Surgical Therapy
DOI:
https://doi.org/10.12970/2310-984X.2013.01.01.5Keywords:
Tumoral calcinosis, Haemodialysis, hyperparathyroidism.Abstract
Tumoral calcinosis is an unusual metabolic complication that is uncommonly seen in chronic dialysis patients with deranged calcium and phosphate metabolism. We report a case that was resistant to medical and surgical treatment, which eventually led to septicemic shock and death. This case highlighted to importance of routine surveillance with radiographic and physical examination of musculoskeletal system in high-risked susceptible dialysis patients, even in the absence of warning signs and symptoms.References
[1] Parfitt AM. Soft tissue calcification in uraemia. Arch Intern Med 1969 124: 544-56. http://dx.doi.org/10.1001/archinte.1969.00300210026004
[2] Olsen KM, Chew FS. Tumoral calcinosis: pearls, polemics, and alternative possibilities. Radio Graphics 2006; 26: 871- 85. http://dx.doi.org/10.1148/rg.263055099
[3] Cofan F, García S, Combalia A, et al. Uremic tumoral calcinosis in patients receiving long term haemodialysis therapy. J Rheumatol 1999; 26: 379-85.
[4] Hamada J, Tamai K, Ono W, et al. Uremic tumoral calcinosis in haemodialysis patients: clinicopathological findings and identification of calcific deposits. J Rheumatol 2006; 33: 119- 26.
[5] Chu HY, Chu P, Lin YF, et al. Uremic tumoral calcinosis in patients on peritoneal dialysis: clinical, radiologic, and laboratory features. Perit Dial Int 2011; 31: 430-9. http://dx.doi.org/10.3747/pdi.2009.00250
[6] Barbour GL, Coburn JW, Slatopolsky E, et al. Hypercalcemia in anephric patients with sarcoidosis: evidence for extra renal generation of 1, 25-dihydroxyvitamin D. N Engl J Med 1981; 305: 440-43. http://dx.doi.org/10.1056/NEJM198108203050807
[7] Carter JD, Warner E. Clinical images: Tumoral calcinosis associated with sarcoidosis. Arthritis Rheum 2003; 48: 1770. http://dx.doi.org/10.1002/art.11148
[8] Taki H, Tobe K. Tumoral calcinosis in systemic sclerosis. Joint Bone Spine 2013; 80: 99. http://dx.doi.org/10.1016/j.jbspin.2012.06.018
[9] Zhang C, Gu J, Cheng X, et al. Familial tumoral calcinosis in two Chinese patients: a case series. J Med Case Rep 2011 19; 5: 394.
[10] Carmichael KD, Bynum JA, Evans EB. Familial tumoral calcinosis: a forty-year follow-up on one family. J Bone Joint Surg Am 2009; 91: 664-71. http://dx.doi.org/10.2106/JBJS.G.01512
[11] Chaabane S, Chelli-Bouaziz M, Jelassi H,et al. Idiopathic tumoral calcinosis. Acta Orthop Belg 2008; 74: 837-45.
[12] Ovali GY, Tarhan S, Serter S, et al. A rare disorder: idiopathic tumoral calcinosis. Clin Rheumatol 2007; 26: 1142- 4. http://dx.doi.org/10.1007/s10067-006-0269-3
[13] Martinez S. Tumoral calcinosis: 12 years later. Semin Musculoskelet Radiol 2002; 6: 331-39. http://dx.doi.org/10.1055/s-2002-36732
[14] Wang AY, Woo J, Sea MM, et al. Hyperphosphatemia in Chinese peritoneal dialysis patients with and without residual kidney function: what are the implications? Am J Kidney Dis 2004; 43: 712-20. http://dx.doi.org/10.1053/j.ajkd.2003.12.032
[15] Nassim JR, Connolly CK. Treatment of calcinosis universalis with aluminium hydroxide. Arch Dis Child 1970; 45: 118-21. http://dx.doi.org/10.1136/adc.45.239.118
[16] McGregor D, Burn, J, Lynn K, et al. Rapid resolution of tumoral calcinosis after renal transplantation. Clin Nephrol 1999; 51: 54-8.
[17] Miyamoto M, Shibagaki Y, Kimura K, et al. complete resolution of tumoral calcinosis after renal transplantation. Urology 2012; 79: e90-1.
[18] Lammoglia JJ, Mericq. Familial tumoral calcinosis caused by a novel FGF23 mutation: response to induction of tubular renal acidosis with acetazolamide and the non-calcium phosphate binder sevelamer. Horm Res 2009; 71: 178-84. http://dx.doi.org/10.1159/000197876
[19] Li SY, Chuang CL. Rapid resolution of uremic tumoral calcinosis after parathyroidectomy. Mayo Clin Proc 2012; 87: e97-8.
[20] Kyriakopoulos G, Kontogianni K. Sodium thiosulfate treatment of tumoral calcinosis in patients with end-stage renal disease Ren Fail 1990; 12: 213-9. http://dx.doi.org/10.3109/08860229009060727
[21] Mori H, Okada Y, Tanaka Y. Etidronate for the treatment of progressive tumoral calcinosis in haemodialysis patients. Intern Med 2007; 46: 1485-6. http://dx.doi.org/10.2169/internalmedicine.46.0280
[22] Schenkier SL, Gertner E. Massive soft tissue calcification causing complete loss of extensor tendon function in renal failure. J Rheumatol 1992; 19: 1640-42.
[23] Lykoudis EG, Seretis K, Ristanis S. Huge recurrent tumoral calcinosis needing extensive excision and reconstruction: report of a rare case and brief literature review. Aesthetic Plast Surg 2012; 36: 1194-7. http://dx.doi.org/10.1007/s00266-012-9923-0
