Multiple ectopic calcifications in subcutaneous tissues with chronic renal failure: A case report

Zhang, RongKai; Li, GuoWei; Yang, Lukun; Ying-qin, LI; Ou, Jinghuan; Zhang, Dawei; Chen, Tao; Feng, Shi‐Ting

doi:10.1016/j.ijscr.2016.09.041

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Longer treatment duration might lead to formation of calcium hydroxyapatite crystals surrounded by connective tissue composed of fibroblasts and compressed collagen fibers, which is hardly absorbed. This hypothesis was borne out by histological evaluation in our study and in previous studies [8, 15]. (3) Increased pre-operative serum hs-CRP levels and reduced postoperative serum phosphate levels.…”

Section: Discussionsupporting

confidence: 74%

“…According to rare case reports, PTX is considered an effective treatment for TC in hemodialysis patients with SHPT [7, 9]. However, hormone deprivation therapy based on successful PTX did not succeed in shrinking TC in some patients [8]. The reasons for these different clinical regressions have not been demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…Kidney transplantation or parathyroidectomy (PTX) seems to be an effective treatment for alleviating SHPT-TC and improving patients’ quality of life [9–11]. However, hormone deprivation therapy based on successful PTX did not succeed in shrinking TC in some patients [8]. The aim of this study was to investigate the relationship between PTX and TC shrinkage.…”

Section: Introductionmentioning

confidence: 99%

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Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism

et al. 2019

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Background Tumoral calcinosis (TC) is a rare disease derived from uremic secondary hyperparathyroidism (SHPT). However, parathyroidectomy (PTX) seems to be ineffective at relieving TC in some patients. In this study, we investigated the relationship between PTX and TC shrinkage. Methods We retrospectively followed up nine TC patients who underwent PTX, dividing them into two groups: those with TC size reduced by > 80% were in the “effective group” (group A), and the rest in the “ineffective group” (group B). Results We enrolled nine patients (7 men; mean age 38.6 ± 10.9 years) with SHPT-related TC. One patient with calciphylaxis was excluded due to sudden death. The efficiency of PTX in causing TC regression was 62.5% (5 patients in group A). Group A had a shorter overall duration of TC (6 [5.5, 6.0] vs. 9 [8.0, 10.0] months; P = 0.02) and higher serum levels of alkaline phosphatase (ALP; 408.0 [217.9, 1101.7] vs. 90.8 [71.0, 102.1] pg/ml; P = 0.03) and high-sensitivity C-reactive protein (hs-CRP; 82.7 [55.0, 112.4] vs. 3.1 [3.1, 4.5] mg/l; P = 0.02). Average calcium supplementation within 1 week of surgery was significantly greater in group A than in group B (96.8 [64.1, 105.3] vs. 20.1 [13.1, 32.7] g; P = 0.04). Patients in both the groups demonstrated similar serum phosphate levels before PTX, but these levels were higher in group B than in group A at follow-up times (3 months, P = 0.03; 6 months, P = 0.03). Conclusions The shorter duration of pre-existing TC and higher ALP levels before PTX, as well as lower serum phosphate levels after PTX, were correlated with effective SHPT-TC shrinkage.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism

et al. 2019

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“…They reported that the PTX effectiveness rate for the treatment of UTC was 62.5% and that the non-absorption of UTC after PTX was related to a history of lower ALP levels and UTC. Zhang et al [24] believed that prolonged persistence of UTC induced more fibroblasts and collagen encasing around calcium hydroxyapatite crystals, and this was one of the reasons why the calcinosis was difficult to absorb after PTX. Bas et al [25] found that macrophages were associated with mineralised resorption and those macrophages could transform into osteoclasts and degrade calcified elastin.…”

Section: Discussionmentioning

confidence: 99%

Parathyroidectomy May Cause Remission of Uraemic Tumoral Calcinosis in Haemodialysis Patients

Huang

Guo

et al. 2022

Indian J Surg

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Few cases of uraemic tumoral calcinosis (UTC) have been reported. This study aimed to investigate the clinical efficacy of parathyroidectomy for UTC. Historical clinical data of patients with end-stage renal disease and UTC who underwent parathyroidectomy were analysed. Absorption of metastatic calcification was compared before and after operation. Changes in intact parathyroid hormone, serum calcium, phosphorus, and alkaline phosphatase levels were analysed before parathyroidectomy and at 1 week and 3, 6, and 12 months after parathyroidectomy. Eight patients met the enrolment criteria (men, 6; mean age, 38.6 SD 10.9 years). Uraemic tumoral calcinosis, which developed 2–8 years after dialysis began, was caused by secondary hyperparathyroidism. Massive calcium deposition was found in the shoulder (n = 6), hip (n = 3), and elbow (n = 2). Four patients had > 2 joints affected, and a single joint was involved for four patients. Seven patients had rapid remission (< 6 months) of the masses after parathyroidectomy. In one patient, the mass remained unabsorbed until 6 months postoperatively. Hypocalcaemia occurred in all patients where parathyroidectomy was successful, and calcium supplementation was required 1 year postoperatively. Serum intact parathyroid hormone levels on day 7 and at 3 and 6 months postoperatively decreased significantly from baseline and remained low 1 year postoperatively (22.015 SD33.134 pg/mL). Postoperative phosphorus levels were significantly lower than preoperative levels (p < 0.05), but no significant difference was found in alkaline phosphatase levels (p > 0.05). Parathyroidectomy has promising efficacy for UTC treatment and regulation of serum intact parathyroid hormone and phosphorus. Hypocalcaemia is a common complication after parathyroidectomy. Current Controlled Trials ChiCTR2000041311, date of registration: Dec. 23, 2020.

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Recent Advances on Relationship Between Inorganic Phosphate and Pathologic Calcification: Is Calcification After Breast Augmentation with Fat Grafting Correlated with Locally Increased Concentration of Inorganic Phosphate?

Luan

2018

Aesth Plast Surg

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Multiple ectopic calcifications in subcutaneous tissues with chronic renal failure: A case report

Cited by 4 publications

References 13 publications

Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism

Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism

Parathyroidectomy May Cause Remission of Uraemic Tumoral Calcinosis in Haemodialysis Patients

Recent Advances on Relationship Between Inorganic Phosphate and Pathologic Calcification: Is Calcification After Breast Augmentation with Fat Grafting Correlated with Locally Increased Concentration of Inorganic Phosphate?

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