A case of metastatic calcification associated with chronic nephritis and hyperplasia of the parathyroids

Hubbard, Roger S.; Wentworth, John A.

doi:10.3181/00379727-18-159

Cited by 35 publications

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“…Calcification of the arteries and around the joints but sparing the viscera, the common site of metastatic calcification, has been described in association with advanced renal failure (Albright and others, 1937;Hubbard and Wentworth, 1921), but both these cases showed evidence of hyperparathyroidism and grossly abnormal biochemical findings in the blood, and neither showed any overgrowth of bone. None of the three patients with this syndrome so investigated showed evidence of metabolic disturbances of this kind, which implies that the calcification is of the dystrophic variety, that is, secondary to a primary disturbance in the tissues.…”

Section: Heredo-familial Vascular and Articular Calcificationmentioning

confidence: 98%

Heredo-Familial Vascular and Articular Calcification

Sharp¹

1954

Annals of the Rheumatic Diseases

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This report concerns a family, several members of which display an unusual type of calcification of joint structures and arteries, calcification and ossification of ligaments, and juxta-articular and periosteal new bone formation.The full syndrome is a readily recognizable clinical entity and appears to be rare, since only two previous reports of similar cases have been traced in the literature. Magnus-Levy (1914) described a patient, a 47-year-old German female, who gave a history of recurrent attacks of painful joint swellings, starting in her teens in isolated fingers and later involving the hands and elbows. Each attack was followed by firm enlargement of the affected joints. She later developed intermittent claudication in the legs and evidence of heart failure. The joints of the fingers were enlarged, there was extensive thickening and tortuosity of the larger limb vessels, and radiologically there were calcifications in relation to the olecranon, patella, and finger joints, and the thickened vessels showed heavy calcification of an unusual pattern. Levitin (1945) reported the case of a 24-year-old American serviceman who complained of painful swelling of the joints of the hands and pain in one knee of 2 weeks' duration. He also had painless swelling of the finger joints and nodular thickening of the arteries of the limbs and the tongue, but there was no obvious abnormality of the peripheral circulation. The radiological changes closely resembled those in Magnus-Levy's patient.Case Reports Case 1. A 47-year-old taxi-driver complained of attacks of painful swelling in the hands and feet, stiffness of the back, and pain in the calves on walking.He gave a history that about 20 years ago he suddenly developed pain and swelling of the dorsum of the right hand with heat and redness of the overlying skin. Over the next few days the wrist and fingers became affected, the whole region being uniformly swollen. Moderate 15 spontaneous pain was present, and movement of the wrist and lingers was excruciatingly painful. The attack gradually subsided in about 4 weeks, leaving slight residual enlargement of the wrist and finger joints. Some months later, an identical attack occurred in the left hand and similar milder attacks were noted subsequently in the feet and on one occasion in the right elbow. He had not felt ill, and did not think that he had been febrile during these episodes. The attacks, always confined to one site, occurred at irregular intervals of about 2 to 6 months, and each attack left further joint enlargement in the affected region with some limitation of movement. During the past 10 years or so, the attacks had been much milder, involving one or sometimes two or three adjacent fingers, and small transitory painful lesions had developed at new sites, particularly over such bony prominences as the ischial tuberosities and heels, and once over the manubriosternal region. In addition, he had noted occasional aching in the larger joints, particularly the knees and shoulders.About 10 years ago, following for...

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Section: Heredo-familial Vascular and Articular Calcificationmentioning

confidence: 98%

Heredo-Familial Vascular and Articular Calcification

Sharp¹

1954

Annals of the Rheumatic Diseases

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“…Not infrequent are the subcutaneous m etastatic calcifications, usually originating in periarticular sites anil forming hard or often also fluc tuating swellings as they grow larger. These have most often been found in association with renal hyperparathyroidism [16][17][18][19][20][21][22][23][24][25][26][27], but also in prim ary hyperparathyroidism [28,29], vitam in 1) intoxication [30][31][32], B urnett's syndrome [33][34][35][36], and sarcoidosis [37][38][39]. They so closely resemble the lesions from metabolic calcinosis or chalk gout described briefly above th at some of the cases have no doubt been put in this group in the absence of the required calcium anil phosphorus determ inations (cp.…”

Section: Discussionmentioning

confidence: 99%

Renal Hyperparathyroidism with Metastatic Calcification of the Skin

Putkonen¹,

Wangel²

1959

Dermatology

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“…This danger is greatest in those patients who have osteitis fibrosa as the dominant skeletal lesion, and who, unlike the majority of patients with renal failure who have low plasma calcium levels (de Wesselow, 1923), have plasma calcium levels that are either within the normal range (Stanbury and Lumb, 1966) or even frankly raised (Hubbard and Wentworth, 1921 ;Smyth and Goldman, 1934 ;Shelling and Remsen, 1935). Stanbury et al (1960) were the first to embark deliberately on a policy of subtotal parathyroidectomy in a patient with severe secondary hyperparathyroidism, and they were subsequently able to heal the bone lesions with vitamin D without producing hypercalcaemia.…”

mentioning

confidence: 99%

Total parathyroidectomy in treatment of secondary (renal) hyperparathyroidism.

Ogg¹

1967

BMJ

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A case of metastatic calcification associated with chronic nephritis and hyperplasia of the parathyroids

Cited by 35 publications

References 0 publications

Heredo-Familial Vascular and Articular Calcification

Heredo-Familial Vascular and Articular Calcification

Renal Hyperparathyroidism with Metastatic Calcification of the Skin

Total parathyroidectomy in treatment of secondary (renal) hyperparathyroidism.

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