Calcinosis universalis: a rare diagnosis

Abstract

Calcinosis universalis is characterized by the deposit of calcium salts in skin, subcutaneous tissue, tendons and muscles. Most cases become apparent during the first decade of life. Clinical aspects may vary from arthralgia to movement limitation, with calcification of soft tissues. Differential diagnosis should exclude fibrodysplasia ossificans progressive, progressive osseous heterodysplasia, myositis ossificans and dermatopolymyositis. There is no specific treatment, but the use of calcium chelates (EDTA), biphosphonates (disodium etidronate) and steroids are mentioned. This paper presents a review of the literature and adds a new case of calcinosis universalis and its evolution in 28 months, describing laboratory and radiograph findings and suggesting the differential diagnosis among processes of soft tissue calcification.

Calcinosis Universalis of the Elbow: A Rare Case with Classical Presentation

“…Laboratory testing of calcium, phosphorus, and parathyroid hormone serum levels in patients with dystrophic calcifications is usually unremarkable [ 6 , 7 ]. So far, laboratory examinations are the most important diagnostic tool to rule out differential diagnoses, such as Hypervitaminosis D, nephropathy, hyperparathyroidism, and progressive osseous heteroplasia [ 6 – 8 ]. Although ossifying myositis and fibrodysplasia ossificans progressiva also present with unremarkable blood testing results, these differential diagnoses can be ruled out by the patient's history and physical examination: ossifying myositis is associated with posttraumatic haematoma, whereas fibrodysplasia ossificans progressiva develops in the first decade of life and typically presents with toe malformations and restrictive lung disease [ 8 ].…”

“…Although there is no gold standard, diagnosis can be made by patient history, clinical presentation, and X-ray films, which visualise the calcific lesions. Additional imaging, laboratory testing, and histological examination may help to confirm diagnosis and to discriminate against other aetiologies such as Hypervitaminosis D, nephropathy, hyperparathyroidism, or progressive osseous heteroplasia [ 8 ]. Calcinosis associated with rheumatic diseases is referred to as dystrophic calcinosis.…”

Subcutaneous fat calcinosis in adult-onset dermatomyositis

“…We demonstrate fascinating images illustrating the development of exclusive subcutaneous fat calcinosis, also known as calcinosis universalis3 4–a phenomenon that is only rarely reported in adult-onset dermatomyositis.…”

Extensive Calcinosis in an Adult Nigerian Woman with Dermatomyositis

“…Pachman et al [14] have also observed an association between calcinosis and a delay in DM diagnosis. Different types of calcifications have been reported, such as calcinosis cutis and calcinosis universalis (dermal calcinosis or diffuse interstitial calcinosis) [15] . Dystrophic calcinosis, as seen in our patient, is the most frequently reported.…”