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Kobayashi S, Takamura T, Tada T, Yamagishi H, Sakaguchi S, Fujimoto N, Kasai A, Dohi K. First Case of COVID-19-Related Left Ventricular Calcification. Circ J 2024; 88:761. [PMID: 38538309 DOI: 10.1253/circj.cj-24-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
| | | | - Tomoko Tada
- Department of Cardiology, Ise Red Cross Hospital
| | | | | | - Naoki Fujimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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Gurupriya M, Anuhya G, Sundarmurthy M, Lakshmi AP, Ram R, Siva Kumar V. Abdominal wall calcification in a peritoneal dialysis patient. Trop Doct 2024; 54:147-148. [PMID: 38093193 DOI: 10.1177/00494755231218773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Abdominal wall calcification in a peritoneal dialysis patient has not previously been reported. We describe a 40-year-old lady, a type 2 diabetic and hypertensive for the past 14 years, who did not have any history, clinical features or laboratory results suggesting autoimmune disease, and had not suffered from tuberculosis in the past, but who had been diagnosed with chronic kidney disease in 2016. She had initiated peritoneal dialysis in December 2018.
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Affiliation(s)
- M Gurupriya
- Junior Resident, Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - G Anuhya
- Junior Resident, Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Mathini Sundarmurthy
- Senior Resident, Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Aishwarya P Lakshmi
- Assistant Professor, Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - R Ram
- Medical Superintendent, Professor and Head, Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - V Siva Kumar
- Senior Professor, Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
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Kim EY, Lee KH, Yun JS, Park YL, Park CH, Jang SY, Ryu JM, Lee SK, Chae BJ, Lee JE, Kim SW, Nam SJ, Yu JH. Impact of residual microcalcifcations on prognosis after neoadjuvant chemotherapy in breast cancer patients. BMC Womens Health 2024; 24:187. [PMID: 38509531 PMCID: PMC10956337 DOI: 10.1186/s12905-024-02973-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Residual microcalcifications after neoadjuvant chemotherapy (NAC) are challenging for deciding extent of surgery and questionable for impact on prognosis. We investigated changes in the extent and patterns of microcalcifications before and after NAC and correlated them with pathologic response. We also compared prognosis of patients depending on presence of residual microcalcifications after NAC. METHODS A total of 323 patients with invasive breast carcinoma treated with neoadjuvant chemotherapy at Kangbuk Samsung Hospital and Samsung Medical center from March 2015 to September 2018 were included. Patients were divided into four groups according to pathologic response and residual microcalcifications. Non-pCRw/mic group was defined as breast non-pCR with residual microcalcifications. Non-pCRw/o mic group was breast non-pCR without residual microcalcifications. pCRw/mic group was breast pCR with residual microcalcifications. pCRw/o mic group was breast pCR without residual microcalcifications. The first aim of this study is to investigate changes in the extent and patterns of microcalcifications before and after NAC and to correlate them with pathologic response. The second aim is to evaluate oncologic outcomes of residual microcalcifications according to pathologic response after NAC. RESULTS There were no statistical differences in the extent, morphology, and distribution of microcalcifications according to pathologic response and subtype after NAC (all p > 0.05). With a median follow-up time of 71 months, compared to pCRw/o mic group, the hazard ratios (95% confidence intervals) for regional recurrence were 5.190 (1.160-23.190) in non-pCRw/mic group and 5.970 (1.840-19.380) in non-pCRw/o mic group. Compared to pCRw/o mic group, the hazard ratios (95% CI) for distant metastasis were 8.520 (2.130-34.090) in non-pCRw/mic group, 9.120 (2.850-29.200) in non-pCRw/o mic group. Compared to pCRw/o mic, the hazard ratio (95% CI) for distant metastasis in pCRw/mic group was 2.240 (0.230-21.500) without statistical significance (p = 0.486). CONCLUSIONS Regardless of residual microcalcifications, patients who achieved pCR showed favorable long term outcome compared to non-pCR group.
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Affiliation(s)
- Eun Young Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kwan Ho Lee
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Sup Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Lai Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chan Heun Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Jang
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Byung-Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea
| | - Jong Han Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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Moinuddin Z, Wang K, Fullwood C, Wiredu E, Hutchison A, Vardhan A, Herrick SE, Summers A, Augustine T, van Dellen D. Renal hyperparathyroidism- a risk factor in the development of encapsulating peritoneal sclerosis. Front Endocrinol (Lausanne) 2024; 15:1282925. [PMID: 38567303 PMCID: PMC10985182 DOI: 10.3389/fendo.2024.1282925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Background Encapsulating peritoneal sclerosis (EPS) is a rare complication of prolonged peritoneal dialysis (PD) exposure, characterised by peritoneal thickening, calcification, and fibrosis ultimately presenting with life-threatening bowel obstruction. The presence or role of peritoneal calcification in the pathogenesis of EPS is poorly characterised. We hypothesise that significantly aberrant bone mineral metabolism in patients on PD can cause peritoneal calcification which may trigger the development of EPS. We compared the temporal evolution of bone mineral markers during PD in EPS patients with non-EPS long-term PD controls. Methods Linear mixed model and logistic regression analysis were used to compare four-monthly serum levels of calcium, phosphate, parathyroid hormone, and alkaline phosphatase (ALP) over the duration of PD exposure in 46 EPS and 46 controls (PD, non-EPS) patients. Results EPS patients had higher mean calcium (2.51 vs. 2.41 mmol/L) and ALP (248.00 vs. 111.13 IU/L) levels compared with controls (p=0.01 and p<0.001 respectively, maximum likelihood estimation). Logistic regression analysis demonstrated that high serum calcium and phosphate levels during PD were associated with a 4.5 and 2.9 fold increase in the risk of developing EPS respectively. Conclusion High levels of calcium and phosphate in patients on PD were identified to be risk factors for EPS development. Possible reasons for this may be an imbalance of pro-calcifying factors and calcification inhibitors promoting peritoneal calcification which increases peritoneal stiffness. Mechanical alterations may trigger, unregulated fibrosis and subsequent development of EPS. Improved management of secondary hyperparathyroidism during PD may ultimately diminish the EPS risk.
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Affiliation(s)
- Zia Moinuddin
- Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary (National Commissioning Group (NCG) funded United Kingdom Referral Centre for EPS Surgery), Manchester, United Kingdom
- School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Kelvin Wang
- Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary (National Commissioning Group (NCG) funded United Kingdom Referral Centre for EPS Surgery), Manchester, United Kingdom
- School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Catherine Fullwood
- Department of Statistics, Research and Innovation, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Centre for Biostatistics, University of Manchester, Manchester, United Kingdom
| | - Elizabeth Wiredu
- Medical Statistics, Data Solution Services, Liverpool, United Kingdom
| | - Alastair Hutchison
- Department of Nephrology, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Anand Vardhan
- Department of Nephrology, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Sarah E. Herrick
- School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Angela Summers
- Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary (National Commissioning Group (NCG) funded United Kingdom Referral Centre for EPS Surgery), Manchester, United Kingdom
- School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Titus Augustine
- Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary (National Commissioning Group (NCG) funded United Kingdom Referral Centre for EPS Surgery), Manchester, United Kingdom
- School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - David van Dellen
- Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary (National Commissioning Group (NCG) funded United Kingdom Referral Centre for EPS Surgery), Manchester, United Kingdom
- School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Sankar L, Norfolk E, Kalra K. Tumoral calcinosis in an end stage kidney disease patient on peritoneal dialysis. Am J Med Sci 2024; 367:e27-e28. [PMID: 37844731 DOI: 10.1016/j.amjms.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/25/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Lakshna Sankar
- Division of Nephrology, Geisinger Medical Center, Danville, PA, USA.
| | - Evan Norfolk
- Division of Nephrology, Geisinger Medical Center, Danville, PA, USA
| | - Kartik Kalra
- Division of Nephrology, Geisinger Medical Center, Danville, PA, USA
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Grosvenor EM, Flower C. Sedimentation Sign in Tumoral Calcinosis in Systemic Sclerosis. J Clin Rheumatol 2024; 30:e68. [PMID: 37936272 DOI: 10.1097/rhu.0000000000002039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Affiliation(s)
- Ebonii-Mykel Grosvenor
- From the Faculty of Medical Sciences, University of the West Indies at Cave Hill, Cave Hill, Barbados
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Annadanam A, Purt B. Dystrophic Calcification in a 3-Piece Silicone Intraocular Lens. JAMA Ophthalmol 2024; 142:e234841. [PMID: 38512158 DOI: 10.1001/jamaophthalmol.2023.4841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
This case report describes a diagnosis of dystrophic calcification of a silicone intraocular lens implant in a patient who presented with foggy vision and glare.
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Affiliation(s)
- Anvesh Annadanam
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
| | - Boonkit Purt
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Gonçalves Júnior J, Shinjo SK. Calcinosis in Juvenile Dermatomyositis-Epidemiology, Pathogenesis, Clinical Features, and Treatment: A Systematic Review. Curr Rheumatol Rep 2024; 26:53-68. [PMID: 38060107 DOI: 10.1007/s11926-023-01126-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE OF REVIEW We performed a systematic review of the literature on the epidemiology, pathogenesis, clinical and laboratory characterization, and treatment of calcinosis in patients with juvenile dermatomyositis (JDM). A qualitative systematic review was conducted from January 1975 to April 2023 according to the PRISMA protocol using three electronic databases: PubMed, Web of Science, and Scopus. Studies were analyzed based on the following eligibility criteria: at least one combination of the terms described in the search strategy appeared in the title, written in English, Portuguese, or Spanish, and addressed the epidemiology, pathogenesis, diagnosis, and treatment of calcinosis in juvenile dermatomyositis. Systematic or scoping reviews, letters, clinical images, book chapters, abstracts, inflammatory myopathy in other connective tissue diseases, idiopathic inflammatory myopathies in adults, and purely qualitative studies were excluded. RECENT FINDINGS Seventy-five studies were included. According to the literature, calcinosis is common in women, around five years old, with three years of disease in association with osteoarticular, cutaneous, pulmonary manifestations, and fever. The pathogenesis is still unknown, but the participation of interleukin 1 and 6, tumor necrosis factor alpha, and innate immunity dysregulation seem to be involved. Common autoantibodies are anti-NXP-2, anti-MDA-5, and anti-Mi-2, and their treatment remains controversial. Prospective, randomized, controlled studies are needed to evaluate treatment protocols and map the natural history of this serious complication. Calcinosis seems to be more common in White female children with muscle weakness, fever, arthritis, severe pulmonary, and skin involvement with anti-NXP-2, anti-MDA-5, and anti-Mi-2 autoantibodies. The multitargets and aggressive treatment is recommended.
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Affiliation(s)
- Jucier Gonçalves Júnior
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil.
- Faculdade de Medicina, Universidade Federal Cariri, UFCA, Barbalha, CE, Brazil.
| | - Samuel Katsuyuki Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
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9
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Kataoka N, Imamura T. Detailed causality between the valvular calcification and recurrent atrial fibrillation after catheter ablation. Clin Cardiol 2024; 47:e24227. [PMID: 38345175 PMCID: PMC10859877 DOI: 10.1002/clc.24227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Affiliation(s)
- Naoya Kataoka
- Second Department of Internal MedicineUniversity of ToyamaToyamaJapan
| | - Teruhiko Imamura
- Second Department of Internal MedicineUniversity of ToyamaToyamaJapan
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10
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Samir A. A large post-stenting intramural hematoma in the left anterior descending artery caused by a small intimal calcium spur; should we respect the calcium shape? BMC Cardiovasc Disord 2024; 24:34. [PMID: 38184530 PMCID: PMC10771661 DOI: 10.1186/s12872-023-03698-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024] Open
Abstract
Coronary heavy calcification (HC) poses a sturdy challenge to percutaneous coronary intervention (PCI). Scores considering calcification length, thickness, or circumferential extent, are widely accepted to dictate upfront calcium modification to improve PCI outcomes. Although often marginalized, calcification shape (morphology) may require consideration during procedure planning in selected cases. This case demonstrates how a focal but spur-shaped calcification led to a massive proximal left anterior descending (LAD) dissecting intramural hematoma.
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Affiliation(s)
- Ahmad Samir
- Faculty of Medicine, Cairo University, Cairo, Egypt.
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Shiari R, Khalili M, Zeinali V, Shashaani N, Samami M, Moghaddamemami FH. Local injection of infliximab into calcinosis lesions in patients with juvenile dermatomyositis (JDM): a clinical trial. Pediatr Rheumatol Online J 2024; 22:2. [PMID: 38166943 PMCID: PMC10759742 DOI: 10.1186/s12969-023-00941-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Juvenile Dermatomyositis (JDM) is a rare autoimmune disorder that primarily affects muscles and skin. One of the severe complications associated with JDM is calcinosis, and treating this condition presents significant challenges. This study aimed to evaluate the efficacy and safety of local injection of infliximab into calcinosis lesions in patients with JDM. METHODS In this clinical trial, five patients diagnosed with JDM and calcinosis lesions were enrolled. The primary treatment consisted of weekly infliximab injections for 16 weeks, targeting all four sides of each lesion. Lesion dimensions, including length and width, were documented and monitored weekly. Before the intervention, patients underwent radiographic imaging. After the final injection in week 16, a follow-up radiographic assessment was performed. Data were analyzed using the Generalized Estimating Equation (GEE) method. RESULTS The lesions' size significantly decreased in both length and width during each visit. On average, the lesion length reduced by 2.66%, and the width shrank by 3.32% per visit. Based on radiographic findings, the average length and width of lesions at the initial visit were 12.09 ± 5.05 mm (range: 6.00-25.50 mm) and 6.35 ± 3.00 mm (range: 2.00-16.00 mm), respectively. The average length and width at the last visit were 5.59 ± 7.05 mm (range: 0-23.00 mm) and 3.41 ± 4.05 mm (range: 0-13.00 mm), respectively. No specific side effects related to the treatment were reported. CONCLUSIONS The results suggest that the direct administration of infliximab into the calcinosis lesions of patients with JDM could be a safe and effective treatment approach. TRIAL REGISTRATION Name of the registry: The effect of infliximab injection into calcinosis lesions on patients with juvenile dermatomyositis (JDM), Trial registration number: IRCT20210808052107N1, Registration date: 2022-07-22, URL of trial registry record: https://en.irct.ir/trial/58329 .
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Affiliation(s)
- Reza Shiari
- Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Khalili
- Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahide Zeinali
- Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloufar Shashaani
- Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Samami
- Dental Sciences Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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12
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Fernandes CB, Ramalho PT. Calcinosis in systemic sclerosis. Int J Rheum Dis 2024; 27:e15037. [PMID: 38287548 DOI: 10.1111/1756-185x.15037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/30/2023] [Indexed: 01/31/2024]
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13
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Bahl G, Upadhyay DK, Varma M, Singh R, Das S, Hussain S. Persistent chronic calcific pancreatitis with intraductal calculi associated with secondary diabetes mellitus type 3 and diabetic ketoacidosis - A case report. Endocr Regul 2024; 58:101-104. [PMID: 38656253 DOI: 10.2478/enr-2024-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Diabetes mellitus type 3 refers to diabetes secondary to an existing disease or condition of the exocrine pancreas and is an uncommon cause of diabetes occurring due to pancreatogenic pathology. It accounts for 15-20% of diabetic patients in Indian and Southeast Asian continents. This is case report of a rare case of type 3 diabetes mellitus (T3DM) presenting with diabetic ketoacidosis (DKA). The patient was admitted for DKA along with complaint of hyperglycemia, blood glucose of 405 mg/dl with HbA1c level of 13.7%. Computed tomography evidence revealed chronic calcific pancreatitis with intraductal calculi and dilated pancreatic duct.
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Affiliation(s)
- Gurusha Bahl
- 1School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India
| | - Dinesh K Upadhyay
- 1School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India
| | - Madhumati Varma
- 2Department of Medicine, Jaipur National University, Institute for Medical Sciences and Research Center, Jaipur, Rajasthan, India
| | - Rajveer Singh
- 1School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India
| | - Subhankar Das
- 1School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India
| | - Sadique Hussain
- 1School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India
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14
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Nóbrega-Catelas D, Correia AL, Cordeiro F, Teixeira-da-Mota P. Acute calcific periarthritis in a proximal interphalangeal joint of the hand after acute trauma: a rare case. Acta Ortop Mex 2024; 38:57-59. [PMID: 38657153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Acute calcific periarthritis (ACP) in the interphalangeal joints of the hand is rare, with less than 100 cases reported. A rare case of ACP in a proximal interphalangeal (PIP) joint of the hand, in a young black woman, after acute trauma, is presented. She experienced severe pain and limited range of motion, and was medicated with an oral corticoid, which was followed by a rapid resolution of the symptoms. At six months, there were no signs of clinical or radiographic recurrence. Recognition of ACP allows for avoiding unnecessary treatments. In this case, treatment with corticoids might have played a role in a faster recovery.
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Affiliation(s)
- D Nóbrega-Catelas
- Department of Orthopedic Surgery, Centro Hospitalar Universitário de Santo António. Porto, Portugal
- School of Medicine and Biomedical Sciences, University of Porto
| | - A L Correia
- Department of Orthopedic Surgery, Centro Hospitalar Universitário de Santo António. Porto, Portugal
- School of Medicine and Biomedical Sciences, University of Porto
| | - F Cordeiro
- Department of Orthopedic Surgery, Centro Hospitalar Universitário de Santo António. Porto, Portugal
- School of Medicine and Biomedical Sciences, University of Porto
| | - P Teixeira-da-Mota
- Department of Orthopedic Surgery, Centro Hospitalar Universitário de Santo António. Porto, Portugal
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15
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Tuzun H, Ak T, Bas A, Kara O, Gulsen F, Seyahi E. Abdominal aortic aneurysm healed with calcification in a female patient with Behçet's syndrome: A case report with a 2-decade follow-up. Int J Rheum Dis 2024; 27:e14859. [PMID: 37540105 DOI: 10.1111/1756-185x.14859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/19/2023] [Indexed: 08/05/2023]
Abstract
Abdominal aortic aneurysms (AAA) are rare in Behçet syndrome (BS) but may result in life-threatening complications. AAA are generally treated with surgical intervention following aggressive immunosuppressive therapy. Healing with wall calcification and mural thrombus for AAA is scarcely reported in the literature. Herein, we present a female patient who developed a large saccular aneurysm in the infra-renal abdominal aorta 6 months after the diagnosis. Endovascular intervention was not found to be possible because of the dimensions of the aneurysm and the patient did not consent for open surgery. Therefore, she received only immunosuppressive treatment. By the second year of follow-up, we detected reduction in the size of AAA, along with circumferential wall calcification and mural thrombus. The patient was followed-up for 20 years without rupture and currently doing well. This case demonstrates that calcified large saccular AAA might not necessitate surgical intervention and be followed-up for many years without any complication.
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Affiliation(s)
- Hasan Tuzun
- Department of Cardiovascular Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Tumay Ak
- Department of Internal Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Ahmet Bas
- Department of Radiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Ozge Kara
- Department of Internal Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Fatih Gulsen
- Department of Radiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Emire Seyahi
- Division of Rheumatology, Department of Internal Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
- Behçet's Disease Research Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Sarna MK, Goel P, Bhargava V, Parakh R. Fahr's syndrome associated with hypoparathyroidism: A case report. J R Coll Physicians Edinb 2023; 53:283-287. [PMID: 37936282 DOI: 10.1177/14782715231210606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Fahr's syndrome affects fewer than 1 in 100,000 people. It is an inherited neurological disorder, which is distinguished by atypical calcium deposition in the movement-controlling areas of brain, that is thalamus, dentate nucleus, basal ganglia, cerebellum, cerebral cortex, hippocampus and subcortical white matter. The majority of patients often experience extrapyramidal symptoms, cerebellar signs, speech difficulty, dementia and neuropsychiatric manifestations. This disease's molecular genetics have not been thoroughly investigated. Typically, young to middle-aged adults are affected though basal ganglia calcification in hypoparathyroidism is quite uncommon. Laboratory results and radiographic brain imaging helps in reaching the diagnosis. The treatment is mainly symptomatic. We present a case of Fahr's syndrome associated with hypoparathyroidism.
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Affiliation(s)
- Mukesh Kumar Sarna
- Department of General Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Pallaavi Goel
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Varun Bhargava
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Rishabh Parakh
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
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Gauffenic A, Ratsimbazafy V, Ostertag A, Linglart A, Bourrat E, Leroy C, Lioté F, Latourte A, Richette P, Ea HK, Guigonis V. Effectiveness of topical sodium thiosulfate for ectopic calcifications and ossifications. Results of the CATSS-O study. Semin Arthritis Rheum 2023; 63:152306. [PMID: 37976811 DOI: 10.1016/j.semarthrit.2023.152306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/02/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Ectopic calcifications (ECs) and heterotopic ossifications (HOs) form in non-mineralized tissues, most often in subcutaneous and muscular areas. Local and systemic complications can cause severe disability. Systemic administration of sodium thiosulfate (STS) gives promising results but is difficult to use in clinical practice. OBJECTIVE Evaluation of the efficacy and safety of topical STS in ECs and HOs. METHODS Retrospective analysis of the CATSS-O registry that included patients receiving topical STS 25 % prepared by the pharmacy of Limoges hospital during 2014-2020. The efficacy of STS was assessed by imaging (radiography or CT) after at least 6 months' treatment. RESULTS Among 126 patients who received STS 25 %, 35 had complete clinical and radiographic data for analysis (28 with ECs and 7 with HOs; 18 children [mean age 8.9 years, range 1.5-16], 17 adults [mean age 52.4 years, range 24-90]). Calcifications or ossifications were due to dermatomyositis (8 children, 6 adults), systemic scleroderma (6 adults) or pseudo-hypoparathyroidism 1A (7 children). They were single (37.1 %) or multiple (62.9 %). Treated regions were in the lower limbs (31.4 %), upper limbs (37.1 %) or both (28.6 %) and the axial region (2.9 %). Topical STS was clinically effective in 9/28 (32.1 %) patients with ECs and 2/7 (28.6 %) children with HOs. Three patients experienced complete disappearance of their calcifications. Response for ECs was better in children than adults (54.5% vs 17.6 %, p = 0.035). Topical STS was well tolerated. CONCLUSION Local STS seems effective for ossifications, particularly pediatric calcifications or ossifications. Randomized and experimental studies are needed to confirm this observation and to identify the underlying mechanisms.
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Affiliation(s)
- Alan Gauffenic
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France; Service de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, APHP.Nord, F-75010 Paris, France
| | - Voa Ratsimbazafy
- University of Limoges, EpiMaCT Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Limoges, France; IRD, U270, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Limoges, France; CHU Limoges, Department of Pharmacy, Limoges, France
| | - Agnès Ostertag
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France
| | - Agnès Linglart
- INSERM-U1185, Paris Sud Paris-Saclay University, 75005 Paris, France; APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Network OSCAR and 'Platform of Expertise Paris Sud for Rare Diseases, 75005 Paris, France; APHP, Endocrinology and Diabetes for Children, 75005 Paris, France
| | - Emmanuelle Bourrat
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris, France
| | - Charles Leroy
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France
| | - Frédéric Lioté
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France; Service de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, APHP.Nord, F-75010 Paris, France
| | - Augustin Latourte
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France; Service de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, APHP.Nord, F-75010 Paris, France
| | - Pascal Richette
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France; Service de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, APHP.Nord, F-75010 Paris, France
| | - Hang Korng Ea
- Inserm UMR 1132 Bioscar, Université Paris Cité, F-75010 Paris, France; Service de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, APHP.Nord, F-75010 Paris, France.
| | - Vincent Guigonis
- Service de Pédiatrie, CHU de Limoges, Limoges, France; CIC 1435, CHU de Limoges, Limoges, France; UMR CNRS 7276, Limoges, France
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18
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Marinelli LM, Arballo OM, Guerrero G, Wohltmann WE. Perforating Calcinosis Cutis as a Complication of Intraosseous Fluid Infusion in the Setting of a Near-Drowning Event. Mil Med 2023; 188:e3703-e3706. [PMID: 36461682 DOI: 10.1093/milmed/usac385] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/03/2022] [Accepted: 11/17/2022] [Indexed: 11/09/2023] Open
Abstract
Iatrogenic calcinosis cutis represents a subset of calcinosis cutis resulting secondary to treatments or procedures. We present the first report of calcinosis cutis resulting from the intraosseous infusion and one of a few cases with associated transepidermal elimination. A previously healthy 2-year-old female presented with a new-onset unilateral shin rash 1 week following hospitalization for a near-drowning event. A dermatologic exam revealed multiple small, tender, firm, chalky-white papules with surrounding erythema, in addition to two erythematous macules superior and medial to the papular lesions, corresponding to prior intraosseous access sites. The rash persisted despite trials of topical mupirocin and acyclovir cream, prompting a referral to a dermatologist. An excisional biopsy was performed, revealing circumscribed dermal deposits of acellular basophilic material connected to the overlying epidermis through an invaginated keratin plug. A von Kossa silver stain highlighted the deposits, confirming the diagnosis of perforating calcinosis cutis. The lesions did not recur following the excisional biopsy. Iatrogenic calcinosis cutis may be seen as a complication of the infusion of calcium-containing fluids via intraosseous access, in addition to the more commonly observed peripheral intravenous access. Awareness of this disorder is important in order to distinguish it from an infectious mimic and guide the selection of therapy.
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Affiliation(s)
- Lisa M Marinelli
- Department of Pathology and Area Laboratory Service, Brooke Army Medical Center, Ft Sam Houston, TX 78234, USA
| | - Olivia M Arballo
- Department of Dermatology, Blanchfield Army Community Hospital, Fort Campbell, KY 42223, USA
| | - Giselle Guerrero
- Department of Internal Medicine, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Wendi E Wohltmann
- Departments of Dermatology and Pathology, Brooke Army Medical Center, Ft Sam Houston, TX 78234, USA
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Liu X, Li T, Sun J, Wang Z. The Role of Endoplasmic Reticulum Stress in Calcific Aortic Valve Disease. Can J Cardiol 2023; 39:1571-1580. [PMID: 37516250 DOI: 10.1016/j.cjca.2023.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/28/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023] Open
Abstract
Calcific aortic valve disease (CAVD), which is involved in osteogenic reprogramming of valvular interstitial cells, is the most common form of valve disease. It still lacks effective pharmacologic intervention, as its cellular biological mechanisms remain unclear. Congenital abnormality (bicuspid valve) and older age are considered to be the most powerful risk factors for CAVD. Aortic valve sclerosis (AVS) and calcific aortic stenosis (CAS), 2 subclinical forms of CAVD, represent 2 distinct stages of aortic valve calcification. During the AVS stage, the disease is characterised by endothelial activation/damage, inflammatory response, and lipid infiltration accompanied by microcalcification. The CAS stage is dominated by calcification, resulting in valvular dysfunction and severe obstruction to cardiac outflow, which is life threatening if surgery is not performed in time. Endoplasmic reticulum (ER) stress, a state in which conditions disrupting ER homeostasis cause an accumulation of unfolded and misfolded proteins in the ER lumen, has been shown to promote osteogenic differentiation and aortic valve calcification. Therefore, identifying targets or drugs for suppressing ER stress may be a novel approach for CAVD treatment.
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Affiliation(s)
- Xiaolin Liu
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Medicial Science and Technology Innovation Center, Shandong First Medical University, Jinan, Shandong, China
| | - Ting Li
- School of Life Science, Shandong First Medical University (Shandong Academy of Medical Sciences), Taian, Shandong, China
| | - Jun Sun
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Zhengjun Wang
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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20
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Borzutzky A, Valenzuela A. Scrotal Calcinosis in Juvenile Systemic Sclerosis. J Rheumatol 2023; 50:1351-1352. [PMID: 36921965 DOI: 10.3899/jrheum.221249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Affiliation(s)
- Arturo Borzutzky
- Department of Pediatric Infectious Diseases and Immunology Pontificia Universidad Católica de Chile
| | - Antonia Valenzuela
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile.
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21
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Agarwal L, Dash NR, Pal S, Agarwal A, Madhusudhan KS. Pattern of Aorto-coeliac Calcification Correlating Cervical Esophago-gastric Anastomotic Leak After Esophagectomy for Cancer: a Retrospective Study. J Gastrointest Cancer 2023; 54:759-767. [PMID: 35965285 DOI: 10.1007/s12029-022-00856-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Cervical esophagogastric anastomotic leak (CEGAL) is a troublesome complication after esophagectomy and gastric pull-up. The aim of the study was to identify the preoperative clinical and radiological factors associated with increased risk of CEGAL. METHODS Consecutive patients whose clinical and imaging data were available and who underwent cervical esophago-gastric anastomosis following esophagectomy and gastric pull-up for esophageal cancer, between January 2013 and January 2021, were included. The patient details were collected from a prospectively maintained database. The demographic, clinical, and laboratory data including preoperative hemoglobin and serum albumin levels were recorded. Preoperative computed tomographic (CT) images were reviewed by two independent radiologists to assign vascular calcification scores for proximal aorta, distal aorta, aortic bifurcation, celiac trunk, and celiac artery branches. The primary outcome evaluated was clinically evident neck leak. Univariate and multivariate analysis of the clinical and radiological factors was performed to identify significant predictors. RESULTS A total of 100 patients (mean age: 54.7 years; 60 males, 40 females) were included in the study and of them, 27 developed CEGAL. Compared to the group without CEGAL, the patient group with CEGAL had significantly higher mean age (60.3 vs. 52.7 years, p < 0.01), and higher incidences of diabetes mellitus (25.9% vs 10.9%, p = 0.03), major proximal aortic calcification (29.6% vs. 6.3%, p < 0.01), and major celiac trunk calcification (22.2% vs. 6.3%, p = 0.02). Multivariate regression analysis identified age and presence of major proximal aortic calcification as independent risk factors for the development of CEGAL. CONCLUSION Major calcification of the proximal aorta and advanced age are independent risk factors for CEGAL after esophagectomy.
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Affiliation(s)
- Lokesh Agarwal
- Department of Gastrointestinal Surgery and Liver Transplant, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110025, India
| | - Nihar Ranjan Dash
- Department of Gastrointestinal Surgery and Liver Transplant, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110025, India.
| | - Sujoy Pal
- Department of Gastrointestinal Surgery and Liver Transplant, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110025, India
| | - Ayushi Agarwal
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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22
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Lau S, Ang B, Tan S. A unique pattern of urothelial calcifications secondary to disseminated tuberculosis. Med J Aust 2023; 219:103. [PMID: 37402478 DOI: 10.5694/mja2.52006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Affiliation(s)
- Samuel Lau
- National University Health System, Singapore
| | | | - Sandra Tan
- National University Health System, Singapore
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23
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Yasmine M, Hanene LF, Dorra BN, Zied J, Dhia K, Kaouther M, Mourad J, Wafa H. Tumor calcinosis revealing a familial hyperphosphatemic disease. Int J Rheum Dis 2023; 26:1619-1621. [PMID: 37031367 DOI: 10.1111/1756-185x.14687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/20/2023] [Accepted: 03/20/2023] [Indexed: 04/10/2023]
Affiliation(s)
- Makhlouf Yasmine
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, 2010, Ksar Said, Tunis, 2010, Tunisia
| | - Lassoued Ferjani Hanene
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, 2010, Ksar Said, Tunis, 2010, Tunisia
| | - Ben Nessib Dorra
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, 2010, Ksar Said, Tunis, 2010, Tunisia
| | - Jlalia Zied
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Department of Pediatric Orthopedics, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
| | - Kaffel Dhia
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, 2010, Ksar Said, Tunis, 2010, Tunisia
| | - Maatallah Kaouther
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, 2010, Ksar Said, Tunis, 2010, Tunisia
| | - Jenzri Mourad
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Department of Pediatric Orthopedics, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
| | - Hamdi Wafa
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Mannouba, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, 2010, Ksar Said, Tunis, 2010, Tunisia
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Britz L, Schickhardt SK, Auffarth GU, Khoramnia R. Opacification of Hydrophilic Acrylic Intraocular Lenses: Overview of Laboratory Methods for Histological Analysis and Replication of IOL Calcification. Klin Monbl Augenheilkd 2023; 240:960-970. [PMID: 37391183 DOI: 10.1055/a-2073-8526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Opacification of intraocular lenses (IOLs) due to material changes is a serious complication that can compromise the good visual outcomes of uncomplicated cataract surgery. In hydrophobic acrylic IOLs, opacification can result from glistening formation, while in hydrophilic acrylic IOLs, there is a risk of calcification due to the formation of calcium phosphates within the polymer. Over time, various methods have been developed to investigate calcification in hydrophilic acrylic IOLs. The aim of this article is to provide an overview of standard histological staining and models used to simulate IOL calcification. Histological staining can be used to detect calcification and assess the extent of crystal formation. The development of in vivo and in vitro replication models has helped to identify the underlying pathomechanisms of calcification. In vivo models are suitable for assessing the biocompatibility of IOL materials. Bioreactors as an in vitro model can be used to investigate the kinetics of crystal formation within the polymer. The replication of IOL calcification under standardized conditions using electrophoresis allows for the comparison of different lens materials with respect to the risk of calcification. The combination of different analytical and replication methods can be used in the future to further investigate the pathomechanisms of calcium phosphate crystal formation and the influence of risk factors. This may help to prevent calcification of hydrophilic acrylic IOLs and associated explantation and complications.
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Affiliation(s)
- Leoni Britz
- Universitäts-Augenklinik, UniversitätsKlinikum Heidelberg, Deutschland
| | | | - Gerd U Auffarth
- Universitäts-Augenklinik, UniversitätsKlinikum Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
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25
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Yildirim TM, Auffarth GU, Henningsen N, Łabuz G, Augustin VA, Son HS, Mackenbrock LHB, Khoramnia R. Differential Diagnosis of Changes in Intraocular Lenses. Klin Monbl Augenheilkd 2023; 240:952-959. [PMID: 37567234 DOI: 10.1055/a-2130-6944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Differentiating between various intraocular lens (IOL) changes can be a challenge. In particular, certain IOL models carry the risk of late postoperative calcification. A major cause of IOL exchange surgery could be avoided if appropriate modifications were made during the IOL manufacturing process. The use of a hydrophilic acrylate carries the risk of IOL calcification, especially when a secondary procedure, such as a pars plana vitrectomy or other procedures using gas or air, is performed. In secondary IOL calcification, there is a wide range of opacification patterns, which are usually located in the centre on the anterior surface of the IOL or sometimes elsewhere. Often, granular deposits accumulate just below or on the surface of the IOL, leading to significant deterioration in visual quality and eventually requiring IOL exchange surgery. Therefore, in the case of eyes requiring secondary surgical intraocular intervention in the future, the use of hydrophilic IOLs should be critically evaluated. With regard to hydrophobic IOL materials, there are clear differences in the susceptibility to the formation of glistenings. Over time, there has been a significant decrease in glistening formation over the past 30 years due to optimisation of the material. With hydrophobic IOLs, special care should also be taken to avoid mechanical damage. In general, the only treatment option for functionally-impairing IOL opacification is surgical lens exchange, which carries potential risks of complications. In cases with a low degree of functional impairment, and especially in eyes with additional ocular diseases, it may be difficult to weigh the risk of additional surgery against the potential benefit. In some cases, it may be more appropriate not to perform an IOL exchange despite the IOL opacification. Recent visualisation methods that allow high-resolution analysis of the opacities in vivo and in vitro may be used in the future to estimate the functional effects of various IOL material changes on the optical quality.
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Affiliation(s)
| | | | | | - Grzegorz Łabuz
- Augenklinik, UniversitätsKlinikum Heidelberg, Deutschland
| | | | - Hyeck-Soo Son
- Augenklinik, UniversitätsKlinikum Heidelberg, Deutschland
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Kittithaworn A, Dogra P, Rahimi L, Sandooja R, Bancos I. Etiology, morphology, and outcomes of adrenal calcifications in 540 adult patients-a retrospective single-center study. Eur J Endocrinol 2023; 189:K1-K6. [PMID: 37474107 PMCID: PMC10387451 DOI: 10.1093/ejendo/lvad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/23/2023] [Accepted: 05/22/2023] [Indexed: 07/22/2023]
Abstract
Sparse data are available on the etiology, morphology, clinical presentation, and outcomes of adrenal calcification. In this single-center retrospective study of 540 consecutive patients (median age 65 years, 45% women) with adrenal calcification on computed tomography (December 2017 to January 2021), most were discovered incidentally (472, 87%). The commonest etiology was idiopathic (389, 72%), followed by the adrenal tumor (113, 21%), hemorrhage (29, 5%), and infiltrative disease (7, 1%). Calcified adrenal tumors were predominantly benign (92, 81%) and primarily adenomas (63, 69%), whereas the most common calcified adrenal malignancy (16, 18%) was metastasis (12, 67%). Calcification (unilateral 94%, bilateral 6%) morphology varied from punctate (313, 58%) to coarse (165, 30%), linear/curvilinear (46, 9%), and rim-like (16, 3%). In summary, adrenal calcifications are usually incidentally discovered unilateral, punctate, or coarse lesions of unclear etiology. Most calcified adrenal tumors are benign and <20% malignant or pheochromocytomas.
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Affiliation(s)
| | - Prerna Dogra
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
| | - Leili Rahimi
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
| | - Rashi Sandooja
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
| | - Irina Bancos
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
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27
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E TY, Yang XJ, Bi C, Xue F, Cao YQ. Idiopathic calcinosis cutis of the buttocks: A case report and review of the literature. Medicine (Baltimore) 2023; 102:e31129. [PMID: 37058037 PMCID: PMC10101305 DOI: 10.1097/md.0000000000031129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 04/15/2023] Open
Abstract
RATIONALE Calcinosis cutis is a rare skin disease, and idiopathic cases are rarely reported. It is characterized by the deposition of insoluble calcium salts in the skin, subcutaneous tissue, superficial muscles, and tendon sheaths. However, no abnormal changes were found in the bone. In this article, we introduce a case of idiopathic calcinosis cutis of the buttocks with a long course and large lesion area. PATIENT CONCERNS A 51-year-old male patient was admitted to the hospital with a chief complaint of 'Due to the discovery of hard nodules with pruritus in the buttocks for 32 years. The patient was a male who was 51 years old. He has been in good health and reported no history of surgery, trauma, infection, metabolic disease, tumor, or other diseases. There was no family history. It is worth noting that the patient has the occupation of driving trucks, which keeps him sedentary. DIAGNOSES The accurate diagnosis of calcinosis cutis was confirmed by postoperative histopathological examination with many local calcifications and multinucleated giant cells in subcutaneous tissue. INTERVENTIONS The patient underwent skin lesion excision and autologous skin grafting under general anesthesia. A medium-thickness skin graft from the left lateral thigh was transplanted into the hip operation area, and a bolus tie-over pressure dressing was applied. After the operation, the patient received anti-infection treatment and was advised to rest in the prone position to prevent extrusion of the operation area. OUTCOMES The postoperative recovery was good, and there was no recurrence after 4 months of follow-up. LESSONS The incidence rate of cutaneous calcinosis is not clear. This patient had a large lesion area, long onset time, an invasion of the fat layer, and the onset site was located in the sacrococcygeal region. It is necessary to choose appropriate treatment methods.
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Affiliation(s)
- Tian-Yu E
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Xin-Jun Yang
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Chen Bi
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Feng Xue
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yong-Qian Cao
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Li J, Li X, Dong X, Ma L, Guo Z, Chen X. Different outcomes following parathyroidectomy in patients with uremic tumoral calcinosis: two case reports. BMC Nephrol 2023; 24:55. [PMID: 36922797 PMCID: PMC10018971 DOI: 10.1186/s12882-023-03107-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Uremic tumoral calcinosis (UTC) is a rare complication in hemodialysis patients, whose mechanism remains incompletely understood. We report two cases with UTC who experienced completely different patterns of regression following parathyroidectomy, although there were no significant differences in serum calcium levels, parathyroid hormone, or phosphorus production between the two patients. CASE PRESENTATION Case 1 had a substantial improvement in soft tissue calcification. However, in Case 2, one calcified mass was partially absorbed, while the others were aggravated with severe microvascular calcification and subcutaneous extravascular calcification. Whole-exome sequencing data revealed five mutation sites associated with atherosclerosis. CONCLUSION The different outcomes in UTC patients after PTX are rare. Further studies are required to elucidate the mechanism of paradoxical changes occurring in patients with UTC after parathyroidectomy.
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Affiliation(s)
- Jialin Li
- Department of Nephrology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China
| | - Xuan Li
- Department of Nephrology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China
| | - Xiuhong Dong
- Department of Gastroenterology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China
| | - Lin Ma
- Department of Nephrology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China
| | - Zhentao Guo
- Department of Nephrology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China.
| | - Xuexun Chen
- Department of Nephrology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China.
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29
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Thoma A. Unusual Cause of Iatrogenic Calcifications. J Clin Rheumatol 2023; 29:e6-e9. [PMID: 36251473 DOI: 10.1097/rhu.0000000000001918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Anna Thoma
- From the Department of Rheumatology and Pain Medicine, Bethesda Hospital, Basel, Switzerland
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30
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Gupta S, Sadan P, Singh R, Kumar A. Metastatic calcification: An uncommon issue in peritoneal dialysis. Natl Med J India 2023; 36:55. [PMID: 37615148 DOI: 10.25259/nmji_99_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Samriti Gupta
- Department of Paediatrics, All India Institute of Medical Sciences, Bilaspur, India
| | | | - Ram Singh
- Department of Nephrology, Indira Gandhi Medical College and Hospital, Shimla Himachal Pradesh, India
| | - Asheesh Kumar
- Department of Nephrology, Indira Gandhi Medical College and Hospital, Shimla Himachal Pradesh, India
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31
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Ramachandran R, Kumar V, Isaac-Coss G, Huang T, Venugopal S. Abdominal Calcifications in a Patient From the Congo Basin with History of Snake Meat Consumption: Radiographic Evidence of Prior Armillifer Infection. J Investig Med High Impact Case Rep 2023; 11:23247096231188249. [PMID: 37477128 PMCID: PMC10363905 DOI: 10.1177/23247096231188249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023] Open
Abstract
We report a case of a 60-year-old asymptomatic male with history of consumption of uncooked snake meat while living in the Congo basin and prior imaging showing multiple abdominal calcifications. Patient had multiple subepithelial colonic lesions identified during screening colonoscopy and microscopic examination of the lesions demonstrated a calcified nodule in the submucosa with overlying normal mucosa. However, no parasite was identified within the calcified nodule. Given the history of consumption of uncooked snake meat and the typical radiographic feature of multiple abdominal calcifications, it is very likely that the patient's radiographic abnormalities are due to prior Armillifer armillatus infection, a parasitic infection acquired from consumption of uncooked snake meat. Patient was asymptomatic at the time of evaluation and was not given anti-parasitic treatment.
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Affiliation(s)
| | | | | | - Tiangui Huang
- New York City Health and Hospitals (Elmhurst), NY, USA
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32
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Shimada T, Kamo R, Daida K, Nishioka K, Hattori N, Tsunemi T. Radiation-induced Brain Calcification Leads to L-dopa-resistant Parkinsonism and Cerebellar Ataxia. Intern Med 2022; 61:3723-3727. [PMID: 35598989 PMCID: PMC9841112 DOI: 10.2169/internalmedicine.8400-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
We experienced a young patient who presented with progressive parkinsonism and cerebellar ataxia. Brain magnetic resonance imaging revealed progressive brain calcification, expanding from the bilateral basal ganglia to the central pons, caused by a delayed reaction to the radiation therapy that she had received to treat craniopharyngioma 14 years earlier. Heterogeneous clinical symptoms due to radiation-induced brain calcification have been described, but parkinsonism has never been reported. While dopamine transporter-single photon emission computed tomography revealed only slight damage to the dopaminergic striatal pathway, the extension of calcification to the periventricular white matter was likely responsible for her parkinsonism.
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Affiliation(s)
- Tomoyo Shimada
- Department of Neurology, Juntendo University School of Medicine, Japan
| | - Ryota Kamo
- Department of Neurology, Juntendo University School of Medicine, Japan
| | - Kensuke Daida
- Department of Neurology, Juntendo University School of Medicine, Japan
| | - Kenya Nishioka
- Department of Neurology, Juntendo University School of Medicine, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Japan
| | - Taiji Tsunemi
- Department of Neurology, Juntendo University School of Medicine, Japan
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33
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Agud-Dios M, Arroyo-Andres J, Rubio-Muñiz C, Zarco-Olivo C, Calleja-Algarra A, de Inocencio J, Perez SIP. Juvenile dermatomyositis-associated calcinosis successfully treated with combined immunosuppressive, bisphosphonate, oral baricitinib and physical therapy. Dermatol Ther 2022; 35:e15960. [PMID: 36286617 PMCID: PMC10078250 DOI: 10.1111/dth.15960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/08/2022] [Accepted: 10/23/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Manuel Agud-Dios
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jorge Arroyo-Andres
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carmen Rubio-Muñiz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carlos Zarco-Olivo
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Jaime de Inocencio
- Department of Pediatric Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Public Health & Maternal and Child Health, Complutense University of Madrid, Madrid, Spain
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Abstract
PURPOSE OF REVIEW The aim of this study was to provide updated information on the prevalence, pathogenesis, diagnostics and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc). RECENT FINDINGS Observational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single-centre observational studies have shown mild benefit with minocycline and topical sodium thiosulfate. SUMMARY Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.
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Affiliation(s)
- Srijana Davuluri
- Stanford School of Medicine, Division of Immunology & Rheumatology, Palo Alto, California
| | - Christian Lood
- University of Washington, Division of Rheumatology, Seattle, Washington
| | - Lorinda Chung
- Stanford School of Medicine & Palo Alto VA Healthcare System, Division of Immunology & Rheumatology, Palo Alto, California, USA
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35
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Wendling D. Disc calcifications: Think of ochronosis. Joint Bone Spine 2022; 89:105395. [PMID: 35504514 DOI: 10.1016/j.jbspin.2022.105395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Daniel Wendling
- Rhumatologie, CHU de Besançon et Université de Franche-Comté, Besançon, France.
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36
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Tiao J, Gaffney R, Fedeles F. A Retrospective Study of Calcinosis Cutis in Patients With Systemic Lupus Erythematosus. J Drugs Dermatol 2022; 21:1137. [PMID: 36219042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Calcinosis cutis (CC) is a very rare and poorly characterized finding in systemic lupus erythematosus (SLE).1 In this retrospective study, we present our experience of 10 individuals with SLE who developed CC, describing the epidemiology, diagnosis, and clinical characteristics of this rare entity.
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37
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Skhiri W, Allagui H, Bouida A, Salem AB, Aouam A, Saad J, Salem R. Masseter idiopathic calcinosis circumscripta: A rare condition. J Stomatol Oral Maxillofac Surg 2022; 123:e402-e404. [PMID: 35235881 DOI: 10.1016/j.jormas.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Calcinosis is defined as a biomineralization occurring in soft tissues leading to ectopic calcification. Isolated and localised calcification in a muscle is rare, and it is called calcinosis circumscripta in opposition to calcinosis universalis wich is seen in juvenile dermatomyositis and polymyositis. According to laboratory findings and clinical history, calcinosis circumscripta can be metastatic, dystrophic or idiopathic. Masseter muscle is rarely involved. Pre-operative diagnosis of masseter idiopathic calcinosis is a challenge because of many differential diagnosis. Here, we report a case of 22 years old women presented with swelling over left middle third of her face. Clinical history, morphologic and laboratory examinations helped considering such a rare diagnosis.
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38
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Hachiro K, Kinoshita T, Hara M, Suzuki T. [A Rapidly Growing Cardiac Calcified Amorphous Tumor in a Peritoneal Dialysis Patient:Report of a Case]. Kyobu Geka 2022; 75:722-725. [PMID: 36156524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A calcified amorphous tumor( CAT) is a non-neoplastic cardiac tumor, which has been reported to be associated with hemodialysis dependent end-stage renal disease. We report a case of CAT attached to mitral annular calcification (MAC) in the posterior leaflet annulus of the mitral valve in a 56-year-old man who had been receiving peritoneal dialysis for three years. The CAT grew to 10 mm long in a half year. Peritoneal dialysis dependent end-stage renal disease is associated with MAC. Additionally, MAC-related CAT has been reported growing rapidly. We should perform periodic echocardiography not only for hemodialysis patients but also for peritoneal dialysis patients. When CAT is diagnosed, operation should be performed early to prevent embolism such as cerebral infarction.
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Affiliation(s)
- Kohei Hachiro
- Department of Cardiovascular Surgery, Omi Medical Center, Kusatsu, Japan
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39
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Dutta P, Sengupta A, Chakraborty S. Epigenetics: a new warrior against cardiovascular calcification, a forerunner in modern lifestyle diseases. Environ Sci Pollut Res Int 2022; 29:62093-62110. [PMID: 34601672 DOI: 10.1007/s11356-021-15718-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
Arterial and aortic valve calcifications are the most prevalent pathophysiological conditions among all the reported cases of cardiovascular calcifications. It increases with several risk factors like age, hypertension, external stimuli, mechanical forces, lipid deposition, malfunction of genes and signaling pathways, enhancement of naturally occurring calcium inhibitors, and many others. Modern-day lifestyle is affected by numerous environmental factors and harmful toxins that impair our health rather than providing benefits. Applying the combinatorial approach or targeting the exact mechanism could be a new strategy for drug designing or attenuating the severity of calcification. Most of the non-communicable diseases are life-threatening; thus, altering the phenotype and not the genotype may reveal the gateway for fighting with upcoming hurdles. Overall, this review summarizes the reason behind the generation of arterial and aortic valve calcification and its related signaling pathways and also the detrimental effects of calcification. In addition, the individual process of epigenetics and how the implementation of this process becomes a novel approach for diminishing the harmful effect of calcification are discussed. Noteworthy, as epigenetics is linked with genetics and environmental factors necessitates further clinical trials for complete and in-depth understanding and application of this strategy in a more specific and prudent manner.
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Affiliation(s)
- Parna Dutta
- Department of Life Sciences, Presidency University, 86/1, College Street, Baker building, 2nd floor, Kolkata, West Bengal, 700073, India
| | - Arunima Sengupta
- Department of Life science & Bio-technology, Jadavpur University, Kolkata, 700032, India
| | - Santanu Chakraborty
- Department of Life Sciences, Presidency University, 86/1, College Street, Baker building, 2nd floor, Kolkata, West Bengal, 700073, India.
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40
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Chen JQ. Fahr's syndrome, intracranial calcification and secondary hypoparathyroidism. QJM 2022; 115:481-482. [PMID: 35298651 DOI: 10.1093/qjmed/hcac078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Q Chen
- From the Department of Neurology, HwaMei Hospital, University of Chinese Academy of Sciences, 41 Xibei Street, Ningbo, Zhejiang 315000 China
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41
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Jeong H, Jeon CH. Periarticular calcifications in dermatomyositis. Korean J Intern Med 2022; 37:697-698. [PMID: 34781422 PMCID: PMC9082436 DOI: 10.3904/kjim.2021.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 12/01/2022] Open
Affiliation(s)
- Hyemin Jeong
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Chan Hong Jeon
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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42
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Affiliation(s)
- Elena Aikawa
- From Brigham and Women's Hospital and Harvard Medical School, Boston (E.A.); and Florida International University, Miami (J.D.H.)
| | - Joshua D Hutcheson
- From Brigham and Women's Hospital and Harvard Medical School, Boston (E.A.); and Florida International University, Miami (J.D.H.)
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43
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Ding Z, Chen W, Zhang C, Wang H, Ma X. Correlation between Serum Magnesium Level and Cardiac Valve Calcification in Patients with Chronic Kidney Disease. Clin Lab 2022; 68. [PMID: 35443599 DOI: 10.7754/clin.lab.2021.210533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The aim of the study was to investigate the correlation between serum magnesium (Mg) level and cardiac valve calcification (CVC) in patients with chronic kidney disease (CKD). METHODS A total of 232 CKD patients hospitalized from August 2016 to December 2020 were divided into CVC and non-CVC groups. Their clinical data and laboratory examination results were compared, the risk factors for CVC in CKD patients were explored using logistic regression analysis, and Spearman's method was used to analyze the correlation between serum Mg level and CVC degree. According to the tertiles of mean serum Mg level, they were assigned into low serum Mg group (≤ 0.96 mmol/L), middle serum Mg group (0.97 - 1.07 mmol/L), and high serum Mg group (≥ 1.08 mmol/L). The relationship of serum Mg level with CVC risk in CKD patients was analyzed through the Cox regression model, and a prediction model was established using independent risk factors. RESULTS Long CKD duration, low serum Mg level, high serum phosphorus (P) level, and high CKD stage were independent risk factors for CVC. Serum Mg level was significantly negatively correlated with the severity of CVC (r = -0.743, p < 0.05). The risk of CVC was significantly higher in low serum Mg group than that in high serum Mg group [hazard ratio (HR) = 2.852, 95% confidence interval (CI): 1.325 - 6.432, p = 0.005]. A CVC prediction model was established based on independent risk factors as follows: CVC predictive value = EXP [0.491 - 0.546 (CKD duration) - 0.454 (serum P level) + 2.145 (serum Mg level) - 0.812 (CKD stage)]/1 + EXP [0.491 - 0.546 (CKD duration) - 0.454 (serum P level) + 2.145 (serum Mg level) - 0.812 (CKD stage)]. The area under curve of the model was 0.750 (95% CI: 0.822 - 0.965), and that of the CVC prediction model for CKD patients in test set was 0.774 (95% CI: 0.761 - 0.975), showing no significant difference from that in training set (p > 0.05). CONCLUSIONS Low serum Mg level serves as an independent risk factor for CVC in CKD patients, and may increase the risk of CVC. Therefore, the serum Mg level in CKD patients should be corrected timely in clinical practice.
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Hsu VM, Kozák E, Li Q, Bocskai M, Schlesinger N, Rosenthal A, McClure ST, Kovács L, Bálint L, Szamosi S, Szücs G, Carns M, Aren K, Goldberg I, Váradi A, Varga J. Inorganic pyrophosphate is reduced in patients with systemic sclerosis. Rheumatology (Oxford) 2022; 61:1158-1165. [PMID: 34152415 PMCID: PMC9052889 DOI: 10.1093/rheumatology/keab508] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/12/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The pathogenesis of calcinosis cutis, a disabling complication of SSc, is poorly understood and effective treatments are lacking. Inorganic pyrophosphate (PPi) is a key regulator of ectopic mineralization, and its deficiency has been implicated in ectopic mineralization disorders. We therefore sought to test the hypothesis that SSc may be associated with reduced circulating PPi, which might play a pathogenic role in calcinosis cutis. METHODS Subjects with SSc and age-matched controls without SSc were recruited from the outpatient rheumatology clinics at Rutgers and Northwestern Universities (US cohort), and from the Universities of Szeged and Debrecen (Hungarian cohort). Calcinosis cutis was confirmed by direct palpation, by imaging or both. Plasma PPi levels were determined in platelet-free plasma using ATP sulfurylase to convert PPi into ATP in the presence of excess adenosine 5' phosphosulfate. RESULTS Eighty-one patients with SSc (40 diffuse cutaneous, and 41 limited cutaneous SSc) in the US cohort and 45 patients with SSc (19 diffuse cutaneous and 26 limited cutaneous SSc) in the Hungarian cohort were enrolled. Calcinosis was frequently detected (40% of US and 46% of the Hungarian cohort). Plasma PPi levels were significantly reduced in both SSc cohorts with and without calcinosis (US: P = 0.003; Hungarian: P < 0.001). CONCLUSIONS Circulating PPi are significantly reduced in SSc patients with or without calcinosis. Reduced PPi may be important in the pathophysiology of calcinosis and contribute to tissue damage with chronic SSc. Administering PPi may be a therapeutic strategy and larger clinical studies are planned to confirm our findings.
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Affiliation(s)
- Vivien M Hsu
- Rheumatology Division, Department of Medicine, Rutgers-RWJ Medical School, New Brunswick, NJ, USA
| | - Eszter Kozák
- Institute of Enzymology, Research Center for Natural Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary
| | - Qiaoli Li
- The Sidney Kimmel Medical College, The PXE International Center of Excellence in Research and Clinical Care, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Márta Bocskai
- Department of Rheumatology and Immunology, University of Szeged, Szeged, Hungary
| | - Naomi Schlesinger
- Rheumatology Division, Department of Medicine, Rutgers-RWJ Medical School, New Brunswick, NJ, USA
| | - Ann Rosenthal
- Rheumatology Division, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Scott T McClure
- Department of Statistics, Shenandoah University, Winchester, VA
- Rebel Analytics, LLC, Laguna Hills, CA, USA
| | - László Kovács
- Department of Rheumatology and Immunology, University of Szeged, Szeged, Hungary
| | - László Bálint
- Genomic Medicine and Bioinformatic Core Facility, Department of Biochemistry and Molecular Biology, University of Debrecen, Hungary University of Szeged, Szeged
| | - Szilvia Szamosi
- Division of Rheumatology, University of Debrecen, Debrecen, Hungary
| | - Gabriella Szücs
- Division of Rheumatology, University of Debrecen, Debrecen, Hungary
| | - Mary Carns
- Divisions of Rheumatology and Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University, Chicago, IL
| | - Kathleen Aren
- Divisions of Rheumatology and Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University, Chicago, IL
| | - Isaac Goldberg
- Divisions of Rheumatology and Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University, Chicago, IL
| | - András Váradi
- Institute of Enzymology, Research Center for Natural Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary
| | - John Varga
- Divisions of Rheumatology and Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University, Chicago, IL
- Rheumatology Division, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
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45
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Affiliation(s)
- T Horino
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - S Inotani
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - H Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - H Ohnishi
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - M Komori
- Department of Otolaryngology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - Y Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
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46
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Affiliation(s)
- Shiro Ono
- Department of General Medicine, Nara Medical University, Japan
| | | | - Kenji Nishio
- Department of General Medicine, Nara Medical University, Japan
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47
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Purra S, Lone AA, Bhat MH, Misgar RA, Wani AI, Bashir MI, Masoodi SR, Purra W. Cardiac structural and functional abnormalities in primary hyperparathyroidism. J Endocrinol Invest 2022; 45:327-335. [PMID: 34324161 DOI: 10.1007/s40618-021-01645-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/17/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Studies on cardiac structural and functional abnormalities in primary hyperparathyroidism (PHPT) have yielded conflicting and inconsistent results. In this prospective case-control study, we sought to compare cardiac structure and function in symptomatic PHPT patients and controls. METHODS One hundred consecutive symptomatic PHPT patients and 113 matched controls underwent echocardiographic evaluation by the same operator. RESULTS Left ventricular mass index (LVMI) was significantly higher in patients as compared to controls, (median of 90.95 g/m2 vs 86.5 g/m2, p = 0.041). Patients had significantly lower early trans-mitral diastolic flow (E velocity) as compared to controls (57.13 ± 14.88 vs 64.76 ± 15.45 cm/s, p < 0.001). Patients also had significantly lower early to late mitral annular velocity (E/A) as compared to controls (0.98 ± 0.37 vs 1.10 ± 0.34, p 0.013). Patients had higher frequency of aortic valve calcification (29% vs 2.65%, p < 0.001), mitral annular calcification (23% vs. 4.42%, p < 0.001), myocardial and septal calcifications (25% vs none, p < 0.001) as compared to controls. Serum PTH, calcium and uric acid significantly correlated with calcifications. Serum calcium showed a negative correlation with E/A ratio. CONCLUSIONS Symptomatic patients with PHPT have substantial cardiac structural and functional abnormalities. These abnormalities include elevated LVMI, diastolic dysfunction, and aortic valve, mitral annular, septal and myocardial calcifications. We strongly suggest and conclude that the evaluation of PHPT patients should not only include traditional end organs like bones and kidneys but also the cardiovascular system in the form of echocardiography to detect subclinical cardiac dysfunction so that the cardiovascular health of such patients can be optimized.
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Affiliation(s)
- S Purra
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - A A Lone
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - M H Bhat
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - R A Misgar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
| | - A I Wani
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - M I Bashir
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - S R Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - W Purra
- Department of Medicine, Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India
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Koga M, Kinoshita Y, Kato H, Kobayashi H, Shinoda Y, Nangaku M, Makita N, Dahir KM, Ito N. Massive calcification around large joints in a patient subsequently diagnosed with adult-onset hypophosphatasia. Osteoporos Int 2022; 33:505-509. [PMID: 34494146 DOI: 10.1007/s00198-021-06145-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
We report a 64-year-old Japanese woman with a history of progressive loss of motor function and painful swelling of large joints. At the age of 54, profound calcification appeared around the shoulder and hip joints, which did not heal after repeated surgical resections. Iliac bone biopsy revealed osteomalacic changes. Laboratory data showed low serum alkaline phosphatase (ALP) activity and a high urine phosphoethanolamine (PEA) concentration with normal serum calcium, phosphate, and fibroblast growth factor 23 (FGF23) levels. Subsequent genetic analysis of the ALPL gene confirmed the diagnosis of hypophosphatasia (HPP) with the identification of a heterozygous single nucleotide deletion, c.1559delT (p.Leu520ArgfsX86). We started a mineral-targeted enzyme replacement therapy, asfotase alfa (AA), to treat the patient's musculoskeletal symptoms. A follow-up bone biopsy after 12 months of AA treatment showed improvement of osteomalacia. Calcified deposits around the large joints were unchanged radiographically. To our knowledge, this is the first report of a patient with an adult-onset HPP who presented with profound calcification around multiple joints. Nonspecific clinical signs and symptoms in patients with adult-onset HPP often result in delayed diagnosis or misdiagnosis. We propose that bone biopsy and genetic analysis should be considered along with laboratory analysis for all patients with ectopic calcification around joints of unknown etiology for accurate diagnosis and better treatment.
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Affiliation(s)
- M Koga
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Y Kinoshita
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Kato
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Kobayashi
- Department of Orthopedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Y Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - M Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - N Makita
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - K M Dahir
- Vanderbilt University Medical Center, Program for Metabolic Bone Disorders, Nashville, TN, USA
| | - N Ito
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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49
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Espósito M, Halac D. [Tumoral calcinosis and chronic kidney disease]. Medicina (B Aires) 2022; 82:804. [PMID: 36220046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Affiliation(s)
- Marcia Espósito
- Servicio de Clínica Médica, Sanatorio Anchorena de San Martín, Buenos Aires, Argentina. E-mail:
| | - Diego Halac
- Servicio de Clínica Médica, Sanatorio Anchorena de San Martín, Buenos Aires, Argentina
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50
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Lecumberri Santamaría B, Ruiz Sánchez JG, de León Fuentes B, Álvarez Escolá C, Herranz de la Morena L. Intracranial calcifications in pseudohypoparathyroidism type 1b: Report of four cases. ENDOCRINOL DIAB NUTR 2022; 69:70-72. [PMID: 35232562 DOI: 10.1016/j.endien.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 06/14/2023]
Affiliation(s)
- Beatriz Lecumberri Santamaría
- Endocrinology and Nutrition Department, La Paz University Hospital, Madrid, Spain; Department of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain; Endocrine Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
| | | | | | - Cristina Álvarez Escolá
- Endocrinology and Nutrition Department, La Paz University Hospital, Madrid, Spain; Department of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain; Endocrine Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Lucrecia Herranz de la Morena
- Endocrinology and Nutrition Department, La Paz University Hospital, Madrid, Spain; Department of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain; Endocrine Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
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