Dangol Gulshan Man Singh, Negrete Hilmer
Department of Internal Medicine, St. Elizabeth Health Center, Youngstown, Ohio, USA.
Department of Internal Medicine, Northeastern Ohio Medical University, Rootstown, Ohio, USA.
Case Rep Nephrol. 2019 Jan 8;2019:9126172. doi: 10.1155/2019/9126172. eCollection 2019.
A 67-year-old woman presented to the hospital with complaints of abdominal pain. Physical exam was significant for signs of severe dehydration, mild epigastric tenderness and multiple non-tender hard nodules over her arms and thighs. Incidental finding of severe hypercalcemia led to negative workups for hyperparathyroidism, vitamin D intoxication, and malignancy. However, elevated levels of 1,25-hydroxy vitamin D raised the possibility of granulomatous diseases. Imaging and patient report revealed silicone-induced foreign body granulomatous reaction as the cause of hypercalcemia. Use of silicone for cosmetic enhancement of body contours can result in siliconomas, severe hypercalcemia, and complications. Treatment is unestablished for this condition. Increasing prevalence of cosmetic enhancement should prompt vigilance for this rare disease entity. Providers should counsel and educate individuals undergoing such procedures.
一名67岁女性因腹痛入院。体格检查发现有严重脱水迹象、轻度上腹部压痛以及双臂和大腿上有多个无压痛的硬结节。偶然发现的严重高钙血症导致甲状旁腺功能亢进、维生素D中毒和恶性肿瘤的检查结果均为阴性。然而，1,25-二羟维生素D水平升高增加了肉芽肿性疾病的可能性。影像学检查和患者报告显示，硅酮诱导的异物肉芽肿反应是高钙血症的病因。使用硅酮进行身体轮廓的美容增强可导致硅瘤、严重高钙血症及并发症。针对这种情况的治疗方法尚未确定。美容增强的患病率不断上升，应提高对这种罕见疾病实体的警惕性。医疗服务提供者应对接受此类手术的个体进行咨询和教育。
