Diffuse Hepatocellular Calcification Developing in a Patient on Chronic Hemodialysis After Ischemic Hepatitis

Kinjo, Kazutoshi; Yamashiro, Masaaki; Akamine, Katsunari; Kinjo, Mitsuyo; Oshiro, Mariko

doi:10.2169/internalmedicine.46.0226

Cited by 12 publications

(5 citation statements)

References 10 publications

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“…Almost all reported cases showed local calcification along with vessel or interstitial calcification, and diffuse liver calcification was extremely rare [ 8 ]. In our search of medical databases, including MEDLINE and Google Scholar, we found only 6 previously reported cases [ 9 – 14 ] ( Table 1 ). The prognosis of these patients tended to be poor, and all of these cases, as well as our case, were supposedly caused by liver ischemia due to systemic shock; this is called ischemic hepatitis or shock liver [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis Patient with Diffuse Liver Calcification After Septic Shock

et al. 2021

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Patient: Female, 82-year-old Final Diagnosis: Diffuse liver calcification Symptoms: Shock Medication:— Clinical Procedure: — Specialty: Nephrology Objective: Rare coexistence of disease or pathology Background: Calcification in arteries is sometimes observed in patients undergoing hemodialysis; however, ectopic calcification in other organs is uncommon. In particular, diffuse liver calcification is very rare. We report a case of rapidly developing diffuse liver calcification in a patient undergoing hemodialysis. Case Report: An 82-year-old woman started hemodialysis because of diabetic nephropathy, and her renal function worsened due to acute coronary syndrome. Percutaneous coronary intervention was conducted, and she was referred to our hospital. However, she subsequently contracted various infections, including a urinary tract infection and pneumonia. On day 43 of hospitalization, she developed septic shock and liver dysfunction due to catheter-induced infection. Although she did not have any medical history of liver disease, hypoperfusion of the liver resulted in liver dysfunction, and a computed tomography scan conducted 3 months later showed diffuse calcification in her liver. Despite recovering from septic shock, she ultimately died of multiple organ failure 21 months after admission to our hospital. Conclusions: Diffuse liver calcification is extremely rare; however, it can be observed in patients undergoing hemodialysis who experience liver hypoperfusion. The precise mechanisms underlying this disorder remain unknown, but a critically ill status and specific characteristics of hemodialysis patients may play important roles in liver calcification.

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Section: Discussionmentioning

confidence: 99%

Hemodialysis Patient with Diffuse Liver Calcification After Septic Shock

et al. 2021

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“…The pathogenesis may, at least to a good part, involve hypercalcemia, i.e., causing metastatic calcification (Ibels 1980). Calcification of liver tissue in uremia has rarely been reported (Shibuya et al 1985a;Ladefoged and Frifelt 1987;Milstein and Moulton 1993;Kinjo et al 2007), also in patients treated with peritoneal dialysis (Abbas et al 1996). Calcifications were found in damaged parenchyma in the centrilobular to midzonal areas of liver lobules, but uremia-induced hepatic calcifications involving the epithelia of proliferated bile ductules have also been described (Kurumaya et al 1989).…”

Section: Hepatic Calcification In Uremiamentioning

confidence: 99%

“…Calcifications were found in damaged parenchyma in the centrilobular to midzonal areas of liver lobules, but uremia-induced hepatic calcifications involving the epithelia of proliferated bile ductules have also been described (Kurumaya et al 1989). Centri-and midzonal hepatic necrosis with intracellular and extracellular calcifications of round or rod-like shape was seen in uremic patients who had received hemodialysis, necrotic hepatocytes sometimes being almost completely replaced by calcium salt deposits (Sugiura et al 1987;Kinjo et al 2007).…”

Section: Hepatic Calcification In Uremiamentioning

confidence: 99%

Hepatic and Perihepatic Involvement in Pneumokonioses and Other Mineral-Induced Diseases

Zimmermann¹

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

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“…Hepatic calcification reportedly develops in the degenerative area of the hepatic lobule following ischemia after serious shock lasting for 2 days [2]. Diffuse hepatocellular calcification has also been reported in patients receiving chronic hemodialysis after ischemic hepatitis [3]. Graft calcification after LT has seldom been reported, but almost of all previously reported cases of graft calcification after LT were attributed to graft dysfunction [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Early graft calcification without graft dysfunction after living donor liver transplantation: two case reports

Hidaka

Huang

et al. 2021

Clin J Gastroenterol

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Graft calcification after liver transplantation (LT) has seldom been reported, but almost of all previously reported cases have been attributed to graft dysfunction. We herein report two cases of graft calcification without liver dysfunction after living donor liver transplantation (LDLT). Two patients who underwent LDLT were found to have graft calcification in the early postoperative period (< 1 month). Calcification in the first case was found at the cut edge of the liver at post-operative day (POD) 10, showing a time-dependent increase in calcification severity. The second patient underwent hepatic artery re-anastomosis due to hepatic artery thrombosis on POD4 and received balloon-occluded retrograde transvenous obliteration of the splenic kidney shunt due to decreased portal vein blood flow on POD6. She was found to have diffuse hepatic calcification in the distant hepatic artery area at 1-month post-operation followed by gradual graft calcification at the resection margin at 6-month post-operation. Neither case showed post-operative graft dysfunction. Calcification of the liver graft after LDLT is likely rare, and graft calcification does not seem to affect the short-term liver function in LDLT cases. We recommend strictly controlling the warm/cold ischemia time and reducing the physical damage to the donor specimen as well as monitoring for early calcification by computed tomography.

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Diffuse Hepatocellular Calcification Developing in a Patient on Chronic Hemodialysis After Ischemic Hepatitis

Abstract: Abstract

Cited by 12 publications

References 10 publications

Hemodialysis Patient with Diffuse Liver Calcification After Septic Shock

Hemodialysis Patient with Diffuse Liver Calcification After Septic Shock

Hepatic and Perihepatic Involvement in Pneumokonioses and Other Mineral-Induced Diseases

Early graft calcification without graft dysfunction after living donor liver transplantation: two case reports

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