尿毒症性肿瘤性钙化症患者甲状旁腺切除术后的不同结局：两例报告。
Different outcomes following parathyroidectomy in patients with uremic tumoral calcinosis: two case reports.
机构信息
Department of Nephrology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China.
Department of Gastroenterology, School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China.
出版信息
BMC Nephrol. 2023 Mar 15;24(1):55. doi: 10.1186/s12882-023-03107-3.
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.
背景
尿毒症性肿瘤性钙化（UTC）是血液透析患者的一种罕见并发症，其发病机制尚不完全清楚。我们报告了两例 UTC 患者，尽管两名患者的血清钙、甲状旁腺激素或磷生成无显著差异，但甲状旁腺切除术后其钙化的消退模式却完全不同。
病例介绍
病例 1软组织钙化有明显改善。然而，在病例 2中，一个钙化肿块部分吸收，而其他肿块则加重，并伴有严重的微血管钙化和皮下血管外钙化。全外显子组测序数据显示有 5 个与动脉粥样硬化相关的突变位点。
结论
PTX 后 UTC 患者的不同结局较为罕见。需要进一步研究阐明甲状旁腺切除术后 UTC 患者发生这种矛盾变化的机制。
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