Papadakis J T, Patrikarea A, Digenis G E, Stamatelou K, Ntaountaki I, Athanasopoulos V, Tamvakis N
Renal Unit, NIMTS Hospital, Athens, Greece.
Nephron. 1996;72(2):308-12. doi: 10.1159/000188861.
Extraskeletal tumoral calcifications (TC) may occur in patients with end-stage renal disease. The TC usually develop in the presence of secondary hyperparathyroidism or a high calcium x phosphate product, while other factors have been also occasionally implicated in their development. At present, no uniformly accepted effective treatment has been described for this condition. We describe a 58-year-old female patient with end-stage renal disease who 7 years after the onset of dialysis presented with pain and movement restriction of various joints. A skeletal X-ray showed huge amounts of periarticular TC. The TC occurred in the absence of hyperparathyroidism or a high calcium x phosphate product as evidenced by hormonal and biochemical examination as well as by a bone biopsy specimen that revealed an adynamic bone disease with significant aluminum staining. Sodium thiosulfate, an inorganic salt that has been claimed to inhibit the formation and to favor the solubility and the mobilization of calcified masses, was administered to the patient, and after a long period of treatment considerable radiological regression of the TC with concurrent clinical recovery was noticed. Aluminum intoxication, along with other factors, was considered to be the cause of TC development. The use of sodium thiosulfate seemed to be a reasonable nonspecific therapeutic approach for the management of TC in this case.
肾外肿瘤性钙化（TC）可发生于终末期肾病患者。TC通常在继发性甲状旁腺功能亢进或高钙×磷乘积的情况下发生，而其他因素偶尔也与它们的发生有关。目前，尚未有针对这种情况的统一公认的有效治疗方法。我们描述了一名58岁的终末期肾病女性患者，透析开始7年后出现多个关节疼痛和活动受限。骨骼X线显示关节周围有大量TC。激素和生化检查以及骨活检标本显示为无动力性骨病且有明显铝染色，这表明TC是在没有甲状旁腺功能亢进或高钙×磷乘积的情况下发生的。给患者使用了硫代硫酸钠，一种据称可抑制钙化肿块形成并促进其溶解和移动的无机盐，经过长期治疗后，发现TC有明显的放射学消退，同时临床症状也有所恢复。铝中毒以及其他因素被认为是TC发生的原因。在这种情况下，使用硫代硫酸钠似乎是一种合理的非特异性治疗TC的方法。
