A case of Paget’s disease in hemodialysis

Cianciolo, Giuseppe; Capelli, Irene; Donati, Gabriele; Persici, Elisa; Cuna, Vania; Corsini, Serena; Stefoni, S

doi:10.5414/cnp73403

Cited by 3 publications

(5 citation statements)

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“…Our two cases had very unusual and strikingly similar presentations, not clearly fitting the classic description of either pure tertiary hyperparathyroidism or Paget's disease. While the coexistence of these two disorders has been reported just recently and remains a possible explanation, these lesions were most compatible with prior reports of disfiguring leontiasis ossea or Sagliker syndrome in this patient population. On physical appearance, they looked very much alike and different from their own past photographs.…”

Section: Discussionsupporting

confidence: 91%

Symmetrical craniofacial hypertrophy in patients with tertiary hyperparathyroidism and high‐dose cinacalcet exposure

Hamrahian

Pitman

Csongrádi

et al. 2012

Hemodialysis International

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We are reporting on a series of two patients with end-stage renal disease on hemodialysis, presented for surgical parathyroidectomy secondary refractory hyperparathyroidism. Both patients had failed maximized medical managements, including higher-than-usual doses of the calcimimetic cinacalcet (270 and 180 mg/day, respectively). On physical exam, both patients had marked symmetrical craniofacial hypertrophy with coarse distortion of facial features, similar in appearance to past reports of Sagliker syndrome. On X-ray and computed tomographic exam, they had peculiar areas of bone absorption on the skull, imitating the radiologic appearance of multiple myeloma. Bone biopsy of the maxilla, however, did not show the expected brown tumor, but rather described only fibrosis and reactive bone formations. This phenotype developed while being on cinacalcet, progressed despite escalation of therapy, and improved only after parathyroidectomy. Both patients developed massive "hungry bone syndrome" after parathyroidectomy necessitating prolonged i.v. calcium infusion. This pattern of severe facial distortion likely represented an adverse consequence of severe tertiary hyperparathyroidism, along with supraphysiologic dose of cinacalcet administration and 25-hydroxy vitamin D deficiency in sensitive individuals. The genetic base of this observation remained unexplained.

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Section: Discussionsupporting

confidence: 91%

Symmetrical craniofacial hypertrophy in patients with tertiary hyperparathyroidism and high‐dose cinacalcet exposure

Hamrahian

Pitman

Csongrádi

et al. 2012

Hemodialysis International

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“…Cardiovascular disease is the most severe and frequent complication in patients with CKD. Mortality from cardiovascular disease is high for all stages of CKD, even though it is dramatically high in dialysis patients (15-30 times higher than the general population) [62][63][64]. Overall, the US Renal Data System Renal Data System 2018 Annual Data showed that patients with kidney disease have a double mortality index compared to their non-CKD counterparts.…”

Section: Morbidity and Mortality Of The Ckdmentioning

confidence: 99%

Rethinking Chronic Kidney Disease in the Aging Population

Perrone

Fontana

Ligabue

et al. 2022

Life

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The process of aging population will inevitably increase age-related comorbidities including chronic kidney disease (CKD). In light of this demographic transition, the lack of an age-adjusted CKD classification may enormously increase the number of new diagnoses of CKD in old subjects with an indolent decline in kidney function. Overdiagnosis of CKD will inevitably lead to important clinical consequences and pronounced negative effects on the health-related quality of life of these patients. Based on these data, an appropriate workup for the diagnosis of CKD is critical in reducing the burden of CKD worldwide. Optimal management of CKD should be based on prevention and reduction of risk factors associated with kidney injury. Once the diagnosis of CKD has been made, an appropriate staging of kidney disease and timely prescriptions of promising nephroprotective drugs (e.g., RAAS, SGLT-2 inhibitors, finerenone) appear crucial to slow down the progression toward end-stage kidney disease (ESKD). The management of elderly, comorbid and frail patients also opens new questions on the appropriate renal replacement therapy for this subset of the population. The non-dialytic management of CKD in old subjects with short life expectancy features as a valid option in patient-centered care programs. Considering the multiple implications of CKD for global public health, this review examines the prevalence, diagnosis and principles of treatment of kidney disease in the aging population.

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Section: Case Reportmentioning

confidence: 99%

“…The prevalence of this disease in patients with advanced renal failure in uncertain, with only 8 cases reported before ours [4][5][6][7][8][9][10][11] . 4 of these cases were patients on hemodialysis [5][6][7][8] and only three on peritoneal dialysis [9][10][11] . Age ranged from 48 to 83 years-old, time on dialysis ranged 3 months to 6 years, most patients had the monostotic variety that involved pelvis, skull, or vertebrae.…”

Section: Case Reportmentioning

confidence: 99%

“…Both can result in reduced bone strength, leading to complications of deformity, arthritis, neurological sequelae and fracture. The occurrence of Pagetś disease in patient with chronic renal failure is a probably underdiagnosed entity and so far this is the eighth reported case [4][5][6][7][8][9][10][11] . A correct imaging diagnosis is fundamental and has important therapeutic implications.…”

Section: Introductionmentioning

confidence: 99%

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Paget´s disease of bone in a patient on peritoneal dialysis

Guillermo¹,

Solís²,

Fernando³

et al. 2021

IJCR

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Paget´s disease of bone is a disorder characterized by disorganized bone remodeling. It´s occurrence in patients with end-stage kidney disease on renal replacement therapy is rare. Here we report a case of Paget´s disease of bone in an 80-year-old male on peritoneal dialysis that presented a high level of alkaline-phosphatase with a mildly elevated parathyroid hormone level and typical imaging findings localized to the pelvis. This is the fourth reported case of Paget´s disease in a patient on peritoneal dialysis and the first treated with denosumab.

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A case of Paget’s disease in hemodialysis

Cited by 3 publications

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Symmetrical craniofacial hypertrophy in patients with tertiary hyperparathyroidism and high‐dose cinacalcet exposure

Symmetrical craniofacial hypertrophy in patients with tertiary hyperparathyroidism and high‐dose cinacalcet exposure

Rethinking Chronic Kidney Disease in the Aging Population

Paget´s disease of bone in a patient on peritoneal dialysis

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