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Recuperation of severe tumoral calcinosis in a dialysis patient: A case report.

  • Report
  • Westermann L; Department of Medicine IV, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.
    Isbell LK; Department of Medicine I, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.
    Breitenfeldt MK; Dialysis Center Freiburg, Freiburg 79100, Germany.
    Arnold F; Department of Medicine IV, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.
    Röthele E; Department of Medicine IV, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.
    Schneider J; Department of Medicine IV, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.
    Widmeier E; Department of Medicine IV, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany. eugen.widmeier@uniklinik-freiburg.de.
  • World journal of clinical cases [World J Clin Cases] 2019 Dec 06; Vol. 7 (23), pp. 4004-4010.
  • English
  • Background: One of the common late sequela in patients with end-stage renal disease (ESRD) is the calcium phosphate disorder leading to chronic hypercalcemia and hyperphosphatemia causing the precipitation of calcium salt in soft tissues. Tumoral calcinosis is an extremely rare clinical manifestation of cyst-like soft tissue deposits in different periarticular regions in patients with ESRD and is characterized by extensive calcium salt containing space-consuming painful lesions. The treatment of ESRD patients with tumoral calcinosis manifestation involves an increase in or switching of renal replacement therapy regimes and the adjustment of oral medication with the goal of improved hypercalcemia and hyperphosphatemia.
    Case Summary: We describe a 40-year-old woman with ESRD secondary to IgA-nephritis and severe bilateral manifestation of tumoral calcinosis associated with hypercalcemia, hyperphosphatemia and tertiary hyperparathyroidism. The patient was on continuous ambulatory peritoneal dialysis and treatment with vitamin D analogues. After switching her to a daily hemodialysis schedule and adjusting the medical treatment, the patient experienced a significant dissolution of her soft tissue calcifications within a couple of weeks. Complete remission was achieved 11 mo after the initial diagnosis.
    Conclusion: Reduced patient compliance and subsequent insufficiency of dialysis regime quality contribute to the aggravation of calcium phosphate disorder in a patient with ESRD leading to the manifestation of tumoral calcinosis. However, the improvement of the treatment strategy and reinforcement of patient compliance enabled complete remission of this rare disease entity.
    (©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.)
Additional Information
Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101618806 Publication Model: Print Cited Medium: Print ISSN: 2307-8960 (Print) Linking ISSN: 23078960 NLM ISO Abbreviation: World J Clin Cases Subsets: PubMed not MEDLINE
Publication: 2014-: Pleasanton, CA : Baishideng Publishing Group
Original Publication: Hong Kong, China : Baishideng Publishing Group Co., Limited, [2013]-
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Keywords: Case report; End-stage renal disease; Hypercalcemia; Hyperparathyroidism; Hyperphosphatemia; Renal replacement therapy - dialysis; Tumoral calcinosis
Date Created: 20191214 Latest Revision: 20200928
20220301
PMC6906553
10.12998/wjcc.v7.i23.4004
31832402