Younes Mohamed, Belghali Safa, Zrour-Hassen Saoussen, Béjia Ismail, Touzi Mongi, Bergaoui Naceur
Service de Rhumatologie Hôpital Fattouma Bourguiba de Monastir, Monastir 5000, Tunisie.
Joint Bone Spine. 2008 Oct;75(5):606-9. doi: 10.1016/j.jbspin.2007.08.012. Epub 2008 Aug 6.
Tumoral calcinosis is a rare complication of chronic hemodialysis whose mechanism is incompletely understood. The treatment is challenging and should target the main precipitating factors, most notably secondary hyperparathyroidism and calcium-phosphate (Ca x P) product elevation.
In this 41-year-old patient, tumoral calcinosis developed in the right hip and subacromial bursa of the right shoulder after 3 years of chronic hemodialysis. Laboratory tests showed hyperparathyroidism with Ca x P elevation. Subtotal parathyroidectomy was performed. Eight months later, there was no evidence of tumoral calcinosis at either of the previously affected sites.
The effectiveness of parathyroidectomy in our patient underlies the key role played by secondary hyperparathyroidism in the pathogenesis of tumoral calcinosis complicating hemodialysis.
肿瘤性钙化是慢性血液透析的一种罕见并发症，其发病机制尚未完全明确。治疗具有挑战性，应针对主要诱发因素，最显著的是继发性甲状旁腺功能亢进和钙磷（Ca×P）乘积升高。
在这位41岁的患者中，慢性血液透析3年后右髋部和右肩肩峰下囊出现肿瘤性钙化。实验室检查显示甲状旁腺功能亢进伴Ca×P升高。进行了甲状旁腺次全切除术。八个月后，先前受累的两个部位均未出现肿瘤性钙化迹象。
甲状旁腺切除术对我们这位患者的有效性表明，继发性甲状旁腺功能亢进在血液透析并发肿瘤性钙化的发病机制中起关键作用。
