Cardiac and pulmonary calcification in a hemodialysis patient: partial regression 4 years after parathyroidectomy
| Autor: | Maurizio Gallieni, Mario Cozzolino, Alberto Bestetti, Diego Brancaccio, Carlo Pozzato, Carpani P, Tarolo Gl, C. Di Leo, Luca Tagliabue |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Lung Diseases Parathyroidectomy medicine.medical_specialty Time Factors Heart Diseases medicine.medical_treatment Urology Phosphates Hyperphosphatemia Settore MED/36 - Diagnostica per Immagini e Radioterapia Renal Dialysis medicine Humans Renal osteodystrophy Settore MED/14 - Nefrologia Hyperparathyroidism medicine.diagnostic_test business.industry Remission Induction Calcinosis General Medicine medicine.disease Surgery Brown tumor Bone scintigraphy Nephrology Calcium Female business Follow-Up Studies Calcification Kidney disease |
| Zdroj: | Scopus-Elsevier Università degli Studi di Milano-IRIS |
| ISSN: | 0301-0430 |
| DOI: | 10.5414/cnp59059 |
| Popis: | Aims: The reversibility of extraskeletal calcifications in dialysis patients is an important and unresolved issue. Although periarticular calcifications have been shown to be reversible, little data are available on vascular or parenchymal calcifications. Case history: A patient on maintenance hemodialysis with severe hyperparathyroidism, hypercalcemia and hyperphosphatemia was admitted to undergo parathyroidectomy. A preoperative total body bone scintigraphy was performed to better evaluate a lytic lesion in the pelvis, the histology of which proved to be a brown tumor. The scan showed the typical findings of renal osteodystrophy, but also a diffuse extra-skeletal uptake of bone tracer in the lungs, kidneys, femoral arteries and myocardium. After surgery, good control of serum calcium, phosphate (Ca x P product < 50 mg 2 /dl 2 ) and PTH levels was maintained during 4 years of follow-up. Bone scans were repeated after 2 and 4 years, showing marked improvement of periarticular uptake at the ends of long bones. Extraosseous calcium deposition was still markedly evident, but progressively decreased (at 4 years: heart --36%, lungs -18%). Conclusion: In this dialysis patient, extraskeletal calcification of visceral organs (particularly in the heart and the lungs) due to prolonged hypercalcemia and hyperphosphatemia was partially reversible by parathyroidectomy followed by good long-term control of serum phosphate and calcium. |
| Databáze: | OpenAIRE |
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