scholarly journals Dystrophic Calcifications in the Breast from Secondary Hyperparathyroidism

Breast Care ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 44-46 ◽  
Author(s):  
Kyoung Min Lee ◽  
Jee Eun Lee ◽  
Eun Suk Cha ◽  
Jin Chung ◽  
Jeoung Hyun Kim ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Correct Diagnosis ◽  
Term Treatment ◽  
Dystrophic Calcification ◽  
Palpable Mass ◽  
Long Term Treatment ◽  
History Of ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Background: Soft tissue calcification is common in patients with secondary hyperparathyroidism who have received long-term treatment with hemodialysis. However, calcifications in the breast parenchyma are not common. We report a case of a woman with dystrophic breast calcifications from secondary hyperparathyroidism. Case Report: A 65-year-old woman presented with a palpable mass in her right breast which she had discovered 1 month ago. She had a medical history of end-stage renal disease. Mammography and ultrasound revealed large dystrophic calcifications in both breasts. Core needle biopsy was performed for calcifications in the right breast, and the pathologic diagnosis was dystrophic calcification in the stroma from secondary hyperparathyroidism. Conclusion: Reviewing our case will contribute to a fast and correct diagnosis in patients with dystrophic breast calcifications and lab results indicating secondary hyperparathyroidism, and will help discriminate these benign lesions from malignancies.

MO960RENAL TRANSPLANTATION FROM A LIVING DONOR WITH RENAL ARTERY FIBROMUSCULAR DYSPLASIA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Eva Paraskevi Andronikidi ◽  
Glykeria Tsouka ◽  
Myrto Giannopoulou ◽  
Konstantinos Botsakis ◽  
Xanthi Benia ◽  
...  
Keyword(s):  
Renal Disease ◽  
Serum Creatinine ◽  
Renal Artery ◽  
Left Renal Artery ◽  
Close Monitoring ◽  
History Of ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Renal transplantation is considered the most effective and less costly modality of renal replacement therapy in patients with end stage renal disease. The disparity between kidney allografts and recipients has led to a global effort to increase the pool of kidney donors. Accordingly, fibromuscular dysplasia (FMD) is no longer considered an absolute contraindication for kidney donation. The incidence of FMD is about 2.3%-5.8% in potential kidney donors. There are few cases in the literature where renal artery stenosis in allografts with known pre-transplantation FMD became worse after transplantation, indicating the importance of a proper follow up in the recipients. This is a case of a living kidney donor with no history of hypertension, proteinuria or elevated serum creatinine, whose intra-arterial digital subtraction angiography revealed FMD lesions in the left renal artery. Method Case report Results A 54-year-old Caucasian female with medical history of hypothyroidism took the decision to offer her kidney to her 37-year-old son who was diagnosed with end-stage renal disease five years ago secondary to diabetes mellitus type I. She had no history for diabetes, hypertension and renal disease. Her vital signs on admission were heart rate of 78 beats/min and blood pressure of 130/70 mmHg. Urinalysis, biochemical profile and serological evaluations were all within normal ranges. Blood urea was 36 mg/dL and serum creatinine was 0.6 mg/dL (eGFR 97ml/min/1.73m2). The abdominal ultrasound and renogram with Tc-99m DTPA showed no remarkable findings. On intra-arterial digital subtraction angiography an abnormal succession of dilatations and multifocal stenoses of the left renal artery, characteristic of medial FMD, was found. The right renal artery was normal. Apart from a dysfunctional permanent left femoral catheter, the patient had no other vascular access for hemodialysis because of Superior Vena Cava syndrome, so he needed urgent transplantation. Taking all of these into consideration, the patient was offered renal transplantation as the best option. A left open donor nephrectomy was performed; the renal artery was divided distal to the stenotic dysplastic area. The allograft was placed at the right iliac fossa of the recipient with arterial and venous anastomosis to the extrarenal iliac vessels. Post-operatively, the recipient had a delayed graft function lasted 13 days. On renal artery Doppler in the allograft we found increased resistance index (RI) that gradually normalized without any intervention. An immunosuppressive regiment of tacrolimus, mycophenolate and prednisone was administered according to our center protocol. At discharge serum creatinine was 1.7 mg/dL (eGFR: 50ml/min/1.73m2). At the year follow-up, the donor was normotensive and had near normal renal function (Cr:1.3mg/dL, eGFR: 70ml/min/1.73m2). The recipient has a well-controlled blood pressure receiving two antihypertensive drugs and maintains a satisfactory renal function. Conclusion Few cases with FMD in renal allografts from living and deceased donors have been described. In a review of 4 studies the authors concluded that the outcome of transplantation with allografts from living donors with medial FMD was satisfactory and these allografts could be used to increase the donor pool. Furthermore, it is strongly recommended to have a thorough pre-transplantation check of the donor as well as a close monitoring of both the donor and recipient after transplantation. This case shows that allografts harvested from carefully selected donors with renal arterial FMD can be successfully used, particularly in urgent conditions. Detailed pre-tranplantation imaging of donor’s renal arteries, selection of the appropriate screening method, as well as close monitoring of both donor and recipient for early interventions after transplantation is of paramount importance.

scholarly journals Surgical approach and clinical outcome of a deforming brown tumor at the maxilla in a patient with secondary hyperparathyroidism due to chronic renal failure

2006 ◽  
Vol 50 (5) ◽  
pp. 963-967 ◽  
Author(s):  
Christianne T.S. Leal ◽  
Paulo G.S. Lacativa ◽  
Elaine M.S. Gomes ◽  
Reinaldo C. Nunes ◽  
Flávio Luiz F. de S. Costa ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Brown Tumor ◽  
Maxillary Bone ◽  
Brown Tumors ◽  
Serum Pth ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage ◽  
Fast Increase

Brown tumors are relatively uncommon but they are serious complications of renal osteodystrophy. We describe a 31-year-old woman with end-stage renal disease who had undergone hemodialysis for nine years and developed severe secondary hyperparathyroidism and a maxilla brown tumor despite increasing doses of oral calcitriol and calcium carbonate. The fast increase of the right maxillary bone tumor led to indication of parathyroidectomy (PTx). Despite normalization of serum PTH there was a slow regression of the mass and the patient still complained about her appearance after two-years of follow-up. Excision of the maxillary mass followed by recontouring of the maxilla was then performed, with adequate masticator rehabilitation.

scholarly journals Ectopic Thoracic Kidney and End-Stage Renal Disease in a 38-Year-Old Nigerian

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
U. E. Ekrikpo ◽  
E. E. Effa ◽  
E. E. Akpan
Keyword(s):  
Left Kidney ◽  
Elevated Serum ◽  
Hypertensive Heart Disease ◽  
Maintenance Haemodialysis ◽  
History Of ◽  
Corticomedullary Differentiation ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage ◽  
Chest Ct Scan

This patient is a 38-year-old housewife who presented with a one-month history of difficulty, in breathing, chest pain and bilateral leg swelling and had a blood pressure of 260/150 mmHg, features of malignant hypertension and hypertensive heart disease. Chest CT scan revealed a chest location of the left kidney. She also had elevated serum urea and creatinine and proteinuria (++). The right kidney was normally located with loss of corticomedullary differentiation. She is on maintenance haemodialysis and is being worked up for possible left nephrectomy.

scholarly journals MON-368 A Case of Uremic Tumoral Calcinosis with Secondary Hyperparathyroidism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Justin Mathew ◽  
Preeti Kishore
Keyword(s):  
Calcium Phosphate ◽  
Soft Tissue ◽  
Secondary Hyperparathyroidism ◽  
End Stage Renal Disease ◽  
Tumoral Calcinosis ◽  
Intact Pth ◽  
Phosphate Product ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Uremic tumoral calcinosis is an uncommon clinical entity that can be seen in patients with end-stage renal disease, characterized by development of calcific deposits in the soft tissue. This condition can cause significant pain and impairment of mobility for patients. While it appears that elevation in calcium-phosphate product and hyperparathyroidism may each play a role in the development of these deposits, these conditions are neither necessary nor sufficient for this process to occur. As a result, the optimal treatment of this condition is not well-established. Case: A 50-year-old man with history of ESRD since 2015 secondary to autosomal dominant polycystic kidney disease on peritoneal dialysis, HTN, and secondary hyperparathyroidism presented to the emergency room with progressive right lateral hip pain, reaching the point where the patient could no longer ambulate. Exam demonstrated a thin man whose right hip was tender to palpation with limited range of motion, as well as a palpable, deep right upper leg mass. Laboratory findings were significant for a creatinine of 14.83mg/dL (n <1.5mg/dL), calcium of 9.1 mg/dL (n 8.5-10.5mg/dL), phosphate of 7.9mg/dL (n 2.5-4.5mg/dL), intact PTH of 1129pg/mL (n 15-65pg/mL), and 25-OH Vit D of 20.4ng/mL (n>30ng/mL). X-ray of the right femur demonstrated a 9cm calcified soft tissue lesion, which was not present on imaging 7 months earlier. Subsequent CT of the pelvis showed a cystic, multilobulated calcified mass in the right gluteus, measuring 6.1 x 3.5 x 7.5cm, consistent with tumoral calcinosis. Attempts to normalize his serum phosphorous level using treatment with phosphate binders or changes to his dialysate had failed previously, and the patient declined transitioning to hemodialysis. Nuclear medicine parathyroid scan demonstrated four-gland hyperplasia, and the decision was made to perform 3.5 gland parathyroidectomy. Two days post-operatively calcium had dropped to 7.7 mg/dL, phosphate to 6.8mg/dL, and intact PTH to 29pg/mL. Conclusions: Uremic tumoral calcinosis is a very rare but potentially debilitating consequence of end-stage renal disease that can be significantly detrimental to quality of life in patients with ESRD. Elevated calcium-phosphate product is frequently implicated in its development, and evidence exists that lowering these levels can lead to complete resolution of these lesions. However, in patients for whom medical therapy is not effective and who have concomitant secondary hyperparathyroidism, subtotal parathyroidectomy is a reasonable treatment option.

Comparing Predictive Modeling Strategies to Decipher Long-term Treatment Risks for End Stage Renal Disease Patients

2017 ◽  
Vol 27 (8) ◽  
pp. 524
Author(s):  
Jennifer C. Gander ◽  
Amita Manatunga ◽  
Stephen O. Pastan ◽  
Kimberly Jacob Arriola ◽  
Rachel E. Patzer
Keyword(s):  
Renal Disease ◽  
Predictive Modeling ◽  
End Stage Renal Disease ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Stage Renal Disease ◽  
End Stage ◽  
Treatment Risks

Peritoneal dialysis

2015 ◽  
Author(s):  
Rajnish Mehrotra ◽  
Jonathan Himmelfarb
Keyword(s):  
Peritoneal Dialysis ◽  
Large Scale ◽  
Term Treatment ◽  
Peritoneal Membrane ◽  
Indwelling Catheter ◽  
Plastic Bags ◽  
Long Term Treatment ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis (PD) requires the periodic instillation of dialysate into the peritoneal cavity and induces the movement of solutes and fluid across the semipermeable peritoneal membrane that allows for the successful management of the uraemic syndrome. Even though this was recognized as far back as 1923, technical limitations precluded the large-scale use of PD for the long-term treatment of end-stage renal disease for 50 years. This changed with the development of an indwelling catheter for PD by Henry Tenckhoff in the late 1960s, the description of the technique of continuous ambulatory peritoneal dialysis by Popovich and colleagues in 1976, and the introduction of plastic bags in lieu of glass bottles in the mid 1970s. It is estimated that over 200,000 patients are undergoing treatment with PD worldwide, accounting for about 15% of the international dialysis population.

scholarly journals Brown Tumor as a Result of Hyperparathyroidism in an End-Stage Renal Disease Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Jesse M. Jakubowski ◽  
Ines Velez ◽  
Shawn A. McClure
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Disease Patient ◽  
Brown Tumor ◽  
Histologic Diagnosis ◽  
Tertiary Hyperparathyroidism ◽  
History Of ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

A 49-year-old male with known history of end-stage renal disease (ESRD) presents with an intraoral exophytic mass of the right mandible. This lesion was given a histologic diagnosis of a Brown tumor.Purpose. To allow physicians to include this lesion in a differential diagnosis when evaluating patients with primary, secondary, or tertiary hyperparathyroidism.

scholarly journals Real-world evidence and optimization of vocal dysfunction in end-stage renal disease patients with secondary hyperparathyroidism

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geng-He Chang ◽  
Fong-Fu Chou ◽  
Ming-Shao Tsai ◽  
Yao-Te Tsai ◽  
Ming-Yu Yang ◽  
...  
Keyword(s):  
Renal Disease ◽  
Secondary Hyperparathyroidism ◽  
Real World ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Electrolyte Imbalance ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Stage Renal Disease ◽  
End Stage

AbstractPatients with end-stage renal disease (ESRD) may demonstrate secondary hyperparathyroidism (SHPT), characterized by parathyroid hormone oversecretion in response to electrolyte imbalance (e.g., hypocalcemia and hyperphosphatemia). Moreover, this electrolyte imbalance may affect vocal cord muscle contraction and lead to voice change. Here, we explored the effects of SHPT on the voices of patients with ESRD. We used data of 147,026 patients with ESRD from the registry for catastrophic illness patients, a sub-database of Taiwan National Health Insurance Research Database. We divided these patients into 2 groups based on whether they had hyperparathyroidism (HPT) and compared vocal dysfunction (VD) incidence among them. We also prospectively included 60 ESRD patients with SHPT; 45 of them underwent parathyroidectomy. Preoperatively and postoperatively, voice analysis was used to investigate changes in vocal parameters. In the real-world database analysis, the presence of HPT significantly increased VD incidence in patients with ESRD (p = 0.003): Cox regression analysis results indicated that patients with ESRD had an approximately 1.6-fold increased VD risk (p = 0.003). In the clinical analysis, the “jitter” and “shimmer” factors improved significantly after operation, whereas the aerodynamic factors remained unchanged. In conclusion, SHPT was an independent risk factor for VD in patients with ESRD, mainly affecting their acoustic factors.

Sign in / Sign up

Export Citation Format

Share Document