Wada A, Nakata T, Tsuchihashi K, Aoyama S, Nanba M, Murakami H, Shimamoto K, Iimura O
Second Department of Internal Medicine, Sapporo Medical College, Japan.
Jpn Circ J. 1993 Jun;57(6):567-72. doi: 10.1253/jcj.57.567.
A 26-year-old man was admitted with a high fever, oliguria, skeletal muscle weakness, and cardiogenic shock which led to a diagnosis of acute myocarditis and acute rhabdomyolysis. During treatment with hemodialysis and calcium supplementation, because of severe hypocalcemia, a massive calcification of both right and left ventricular myocardium gradually became apparent with repeated computed tomographic (CT) examinations. Technetium-99m scannings more clearly delineated the markedly accumulated calcium in the myocardium, while significant activity was not detected in other soft tissues. Histopathological examinations by myocardial biopsy revealed a large amount of fibrosis and calcium deposits, and serial CT scans showed a gradual regression of the calcium deposition, suggesting that this rare form of massive dystrophic calcification may parallel changes in the severity of myocarditis, and may be associated with abnormalities in calcium metabolism secondary to rhabdomyolysis-induced acute renal failure.
一名26岁男性因高热、少尿、骨骼肌无力和心源性休克入院，诊断为急性心肌炎和急性横纹肌溶解症。在进行血液透析和补钙治疗期间，由于严重低钙血症，经反复计算机断层扫描（CT）检查，左右心室心肌逐渐出现大量钙化。锝-99m扫描更清晰地显示了心肌中明显积聚的钙，而在其他软组织中未检测到明显活性。心肌活检的组织病理学检查显示大量纤维化和钙沉积，连续CT扫描显示钙沉积逐渐消退，提示这种罕见的大量营养不良性钙化形式可能与心肌炎严重程度的变化平行，并且可能与横纹肌溶解所致急性肾衰竭继发的钙代谢异常有关。
