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Self-healing dystrophic calcinosis following trauma with transepidermal elimination.

An unusual case of dystrophic calcinosis that occurred following trauma is presented. Calcinosis cutis is the deposition of calcium phosphate into the skin. It is classified as dystrophic if calcium and phosphorous levels are normal and tissue damage is present, idiopathic if calcium and phosphorous levels are normal and no tissue damage is present, or metastatic if there is hypercalcemia or hyperphosphatemia. The numerous causes of underlying tissue damage associated with dystrophic calcinosis are discussed.

Adolescent↗

[Cattle calcinosis in the Lower Austria Alpine foothills area].

It is reported on cases of calcinosis during winter 1979/80 occurring on 42 farms and leading to 34 forced slaughters and on the control of this disease in a localized region of the Alpine foot-hills. Instruction of the farmers, ploughing up of the meadows with following new sowing of grass without golden oat (Trisetum flavescens) allowed to push back calcinosis in high situated especially endangered farms. The different calcinogenic activity of golden oat in the different stages of growing, pushing back the golden oat by repeated utilisation of the pastures and keeping the cattle in the stable were successful methods. Additionally it was possible to influence the quantity of golden oat in pastures and meadows by methods influencing the growing such as climate, altitude, quality and quantity of fertilizer, age of the meadows. The importance of the Alpine pastures for prevention of calcinosis in cattle is pointed out.

Animals↗

Tumoral calcinosis associated with sarcoidosis and positive bone and gallium imaging.

A 63-year-old female with biopsy proven tumoral calcinosis presented with progressive and recurrent swelling and tenderness of the right hip, thigh, elbow, and wrist. Both gallium and bone imaging demonstrated intense, congruent uptake in these areas. This is the third case of tumoral calcinosis with sarcoidosis documented in the literature. However, these are the first published bone and gallium scans in a patient with a history of sarcoidosis and tumoral calcinosis.

Calcinosis↗

Ultrastructural changes in inherited cardiac calcinosis of DBA/2 mice.

Cardiac dystrophic calcinosis, an inherited condition in DBA/2 mice, produced extensive calcific lesions in the right ventricular myoepicardium of affected mice. The morphogenesis of the cardiac alterations was evaluated by microscopic and ultrastructural studies. The initial event was necrosis and mineralization of subepicardial myocytes. Mineral deposits were seen as dense granular and spicular deposits in mitochondria only, mitochondria and adjacent sarcoplasm, or the entire sarcoplasm in necrotic myocytes. In mature myoepicardial calcific lesions, the remnants of necrotic myocytes were seen as scattered dense masses of mineralized debris with surrounding fibroplasia and occasional macrophages and giant cells. Male weanling DBA/2 mice (n = 135) were fed either a commercial diet adequate in selenium-vitamin E (Se-E) content, or a basal semipurified Se-E-deficient diet with or without silver acetate for 15, 20 or 25 weeks. Cardiac calcinosis severity seemed to increase in mice which developed concurrent Se-E deficiency. Cardiac calcinosis in the DBA/2 mouse is a useful model of cardiac calcification.

Animals↗

[Calcinosis of the mitral valve ring: echocardiography and clinical data].

The clinical and echocardiographic picture of calcinosis of the mitral valve ring is described in 40 patients (mostly females of advanced age). Echocardiographic correlates and auscultatory manifestations of mitral calcinosis are analysed. Differential diagnosis against valvular heart defects is presented. The contribution of mitral calcinosis to the development of degenerative atrioventricular and intraventricular block is discussed.

Adult↗

[Possibilities in the future application of calcium antagonists. Is the prevention of blood vessel calcinosis possible?].

One of the most important effects of the new pharmacological family of Ca-antagonistic drugs is the prevention of deleterious myocardial Ca overload which is the decisive etiological factor in the production of cardiac necroses, as for instance b-adrenergic overstimulation. However, at an advanced age, also in the human arterial walls, cytotoxic degrees of Ca overload are reached, which probably play an important role in the pathogenesis of arteriosclerotic lesions. It is interesting that severe diabetics and heavy smokers exhibit a much faster progression of age-dependent arterial calcinosis than normal human subjects. In rats the Ca antagonists verapamil and diltiazem not only prevented arterial calcinosis due to overdoses of vitamin D and dihydrotachysterol, but also counteracted age-dependent Ca accumulation. Most impressive effects were also obtained in spontaneously hypertensive rats; chronic oral treatment with nifedipine and other 1,4-dihydropyridines as well as with verapamil kept both blood pressure and Ca content of the arterial walls (aorta, A. mesenterica) in the normal range. Our findings nourish the hope that suitable Ca antagonists can possibly interfere with arterial calcinosis also in humans, thus bearing a new vasoprotective indication.

Animals↗

Tumoral calcinosis.

The authors present a case of tumoral calcinosis, a rare form of calcinosis due to the formation of "calcium tumours" in the vicinity of serous bursae. They discuss the clinical, anatomical and pathological features of the three principal forms of calcinosis, including the theories of pathogenesis. In the rare tumoral form the treatment is always radical excision.

Adolescent↗

[Calcinosis of childhood dermatomyositis. Apropos of 10 cases].

Twenty-eight children were diagnosed as having dermatomyositis (DM) on the basis of the criteria of Bohan and Peter. Ten of the 28 children developed calcinosis. Calcium deposits mainly occurred in DM with gradual onset of symptoms and with a chronic course. Calcinosis always appeared insidiously and early during the active stage of the disease. It persisted for a long time beyond the remission of the active muscle symptoms without tendency to spontaneous resolution. Long-term follow-up data substantiate calcinosis as the most frequent and the most serious sequela in this series of childhood DM.

Calcinosis↗

Family occurrence and hla system in tumoral calcinosis.

A 35-year-old patient, from a ten sibling family, was eight years old at the first presentation of tumoral calcinosis. Since then, in spite of several surgical excisions, the masses have increased in number and size are to be found in various para-articular areas. One brother and one sister of the patient, of 39 and 45 years respectively, had also had tumoral calcinosis, but recovered completely, on surgical removal of the masses. The HLA system studies carried out in the siblings revealed the HLA A10 BW16 haplotype in nine of them, including the three patients. If confirmed in other cases, our data might indicate that tumoral calcinosis is a disease associated with the HLA system.

Adult↗

Cutaneous calcinosis in localized discoid lupus erythematosus.

Cutaneous calcinosis is reported in the lesions of a woman with long-standing discoid lupus erythematosus. Calcium deposits were found in the middle and deep parts of the dermis surrounded by homogeneous collagen staining positively with Alcian blue solution. In contrast to the relative frequency of this event in patients with scleroderma or dermatomyositis, calcinosis cutis occurs very rarely in lupus erythematosus. To the best of our knowledge, this is the first report of calcinosis cutis in discoid lupus erythematosus.

Adult↗

[Calcinosis and its meaning in heart surgery].

The paper presents the analysis of calcinosis frequency and expressivity of calcinosis revealed during surgical treatment of 598 patients with acquired heart defect. In operative interventions under EKG conditions calcinosis was observed in 25% cases, and in performance of closed mitral commissurotomy in 36.7%. Retrospective analysis of special features of the illness course in 346 patients with rheumatic mitral defect accompanied by predominant stenosis in dependence on presence and degree of stenosis expessivity. The role of calcinous conglomerates as chronic intracardiac infection reservoirs is noted.

Calcinosis↗

Differential diagnosis between fibrodysplasia ossificans progressiva and childhood dermatomyositis with calcinosis.

Both fibrodysplasia ossificans progressiva (FOP) and childhood dermatomyositis with calcinosis are rare diseases, and present with ossifying or calcifying processes. Six cases of FOP and one case of childhood dermatomyositis with calcinosis are studied. All six FOP patients had the typical digital anomalies and the characteristic ectopic bone formation starting from the trunk. Calcification in the case of childhood dermatomyositis occurred in the limbs. A carefully differentiated diagnosis between these two diseases is needed, because they share common clinical and radiologic features, but require different management. Delay in the diagnosis of FOP is common, although early recognition of FOP prevents a child from accidental or iatrogenic injury, which can precipitate ectopic ossification. Surgical removal of the ectopic bone or release of the contracture in three FOP patients was followed by rapid recurrence. Entrapment neuropathy and a mild myopathic pattern in two FOP patients, who underwent nerve conduction and electromyographic studies, were secondary to ectopic bone formation. One FOP patient received a computed tomography examination which showed basal ganglia calcification. No coexistence of FOP and childhood dermatomyositis with calcinosis was found.

Adolescent↗

[Method of surgical treatment of mitral valve stenosis depending on the extent of its calcinosis].

On the basis of studying the immediate and long-term results of treatment of 329 patients with calcinated mitral stenosis, the progressive aggravation of the immediate outcome of the operation in II and III-IV degree of mitral valve calcinosis is demonstrated. The data have been confirmed by actuarial analysis of the patients' survival and stability of a good result. The authors consider it expedient to perform mitral commissurotomy only in patients without valvular calcinosis and I degree calcinosis. In more severe affection, mitral valve replacement is indicated.

Actuarial Analysis↗

[Post-Herpes Zoster calcinosis].

INTRODUCTION: Cutaneous calcinosis, without any disturbance of phosphocalcic metabolism, secondary to circumscribed previous skin lesions are quite common. Those secondary to viral skin lesions are rare and worth of publication. CASE REPORT: A 73-year old female patient disclosed progressive calcinosis in the scar of a cervico-thoracic herpes zoster which occurred 20 years ago. DISCUSSION: The occurrence of a secondary calcinosis in an old scar is common and non specific: the eliciting role of a previous herpes virus infection (VZV) may be discussed in the reported case and in few other cases reported in the literature (HSV, CMV)

Aged↗

[Teutschlaender lipo-calcino-granulomatosis or tumoral calcinosis of Inclan (author's transl)].

The present report describes a typical case of tumoral calcinosis. Differential diagnosis was initially directed towards sarcoma suggested by fibrous connective tissue surrounding cystlike cavities. The course of this disease led to chronic multiple fistulae with secondary infection in spite of two attempts of surgical excision. This case adds further support to the results of earlier reports showing no specific biological abnormalities. The present sutyd indicates otherwise that tumoral calcinosis and lipo-calcino-granulomatosis of Teutschlaender are the same condition. The pathogenesis of this affection remains enigmatic; there is no evidence that the lipidic excess should be the beginning of the process, but this disease must be considered as a distinctive form of calcinosis. The surgical exeresis is the only possible treatment, even if it doesn't prevent recurrence.

Adult↗

Regression of calcinosis during diltiazem treatment in juvenile dermatomyositis.

An 8-year-old girl with juvenile dermatomyositis (DM) developed dystrophic calcifications 26 months after diagnosis. She also had severe steroid induced bone loss (osteoporosis). The calcifications turned into generalized heterotopic calcinosis with an exoskeleton-like pattern, despite successful treatment of her myopathy with methylprednisolone and immunosuppressive drugs. She was subsequently treated with oral diltiazem (5 mg/kg/day) to control calcinosis and oral pamidronate (4 mg/kg/day) in addition to calcium and vitamin D supplementation, which she had been taking for 3 years. After 21 months of treatment, clinical and radiological examination revealed dramatic regression of the calcinosis. Bone mass reached normal levels, as determined by bone absorptiometry. Diltiazem alone or in combination with other drugs could be a useful therapy in patients with juvenile DM and pronounced calcifications.

Calcinosis↗

[The effect of isradipine on lipid parameters in calcinosis in rats induced by vitamin D3].

BACKGROUND AND OBJECTIVE: The model of vitamin D3-induced calcinosis in rats makes it possible to follow important aspects of lipid and lipoprotein metabolism regulation not only in vessels, but also in the myocardium and in other organs of experimental animals. THE AIM of this paper is to follow the influence of isradipine on some lipid parameters in the serum, in aorta and myocardium. METHODS: D3 vitamin, isradipine, olive oil and the solvent for isradipine respectively were administered to experimental animals, males of Wistar rats. The animals of the control group (I) received olive oil in dose 0.5 ml/100 mg of bodyweight and the solvent for isradipine in dose 1 ml/100 mg of bodyweight. The second group (II) received D3 vitamin in dose 300000 i.u./kg of bodyweight. The third group (III) got pure isradipine in dose 0.25 mg/100 mg of weight and pure olive oil. The fourth group (IV) got D3 vitamin in the experimental same dose as the second group and a subsequent dose of 0.25 mg/100 mg of bodyweight. RESULTS: The animals were divided into 4 groups. The first group (I) were the controls. The second group (II) received D3 vitamin. We detected a significant increase in triacylyglycerol values by 12.4 per cent and in total lipids by 30.3 per cent, respectively an increase in triacylgycerols in myocardium by 188.8 per cent. The serum level of total cholesterol increased by 123.6 per cent and the level of LDL by 263.6 per cent. In the third group (III) the animals received only isradipine. In this group, the value of triacylglycerols in aorta decreased by 52.5 per cent, respectively and so did the total lipids by 22.4 per cent. The values of triacylglycerols in myocardium were decreased by 17.2 per cent and the total lipids by 6.2 per cent in contrast to the second group, where vitamin D3 was applied. The changes in the values of serum cholesterol were not significant. In the fourth group (IV) the experimental animals received vitamin D3 with isradipine. The values of total lipids and triacylglycerols were higher than these in group III, but in any of them did not attain the values of the second group, where only vitamin D3 was applied. CONCLUSIONS: The model of experimental calcinosis opens new possibilities of study of the pathomechanism of some manifestations of atherosclerosis, as well as the possibilities of their influence. Our results testify a positive influence of isradipine on the development of experimental calcinosis. (Fig. 4, Ref. 34.)

Animals↗

[Idiopathic calcinosis of the scrotum. Cytohistologic diagnosis in biopsy and puncture samples].

OBJECTIVE: To report an uncommon case of idiopathic calcinosis of the scrotum. METHODS/RESULTS: A case of idiopathic scrotal calcinosis in a 50-year-old male who presented with multiple hard masses in the scrotum is described. Cytological (fine needle aspiration) and histological (biopsy and resection) analyses of these lesions were performed. CONCLUSIONS: Although the etiopathogenesis of scrotal calcinosis remains unknown, the involvement of a dystropic mechanism has recently been described. The usefulness of fine needle aspiration, a method that has gradually been included in the study of testicular pathology, is underscored.

Calcinosis↗