Augusta University Medical Center, Medical College of Georgia, Augusta, GA, USA.
Medstar Washington Hospital Center, Washington, DC, USA.
J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620940482. doi: 10.1177/2324709620940482.
Calcinosis cutis refers to the deposition of calcium salts in the cutaneous and subcutaneous tissue and is frequently associated with inflammation. Gastric calcinosis can be classified into metastatic, dystrophic, and idiopathic; metastatic calcinosis is the most common type. In metastatic calcification, calcium salts are deposited in normal soft tissues in the setting of altered metabolism of serum calcium and phosphorus and is a rare and serious complication of chronic renal failure. The important factors contributing to the development of metastatic calcinosis are hypercalcemia, hyperphosphatemia, and an elevated calcium-phosphate product. The most striking feature of this diagnosis is the calcification around the large joints. While it mostly involves dermis of small and medium-sized vessels, it can rarely affect the mucosal layers of the gastrointestinal (GI) tract. Calcinosis presents as a marker for the presence of calcifications in other organs, such as heart or lung, which can be life-threatening. Patients rarely present with clinical symptoms of GI upset, dyspepsia, or epigastric pain that are attributed to calcinosis. If patients present with GI symptoms, infectious causes remain to be higher on the differential. We present a case of incidental finding of gastric mucosal calcinosis during the workup and treatment of dysphagia.
皮肤钙质沉着症是指钙盐在皮肤和皮下组织中的沉积,常与炎症有关。胃钙质沉着症可分为转移性、营养不良性和特发性;转移性钙质沉着症最常见。在转移性钙化中,钙盐沉积在血清钙和磷代谢改变的正常软组织中,是慢性肾衰竭的一种罕见且严重的并发症。导致转移性钙化发生的重要因素是高钙血症、高磷血症和钙磷产物升高。这种诊断最显著的特征是大关节周围的钙化。虽然它主要累及中小血管的真皮层,但也很少累及胃肠道 (GI) 黏膜层。钙质沉着症表现为其他器官(如心脏或肺部)存在钙化的标志物,这可能危及生命。患者很少出现与钙质沉着症相关的胃肠道不适、消化不良或上腹痛等临床症状。如果患者出现胃肠道症状,鉴别诊断仍以感染性病因可能性较大。我们报告了一例在吞咽困难的检查和治疗过程中偶然发现胃黏膜钙质沉着症的病例。