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At least 1,405 records · Page 78Linked to original sources
PubMed2001

[48-year old woman with diffuse pulmonary calcifications after allogeneic kidney transplantation. A rare manifestation of tertiary hyperparathyroidism].

HISTORY: A 48-year-old woman was hospitalized because of the presence of asymptomatic bilateral pulmonary infiltrates in the conventional chest radiograph. An antibiotic treatment administered 3 months before had been without any effect on the radiological aspect. The patient had had an end-stage renal disease of unknown cause and was on hemodialysis since 1993. 1997 she received a cadaveric renal transplant. INVESTIGATIONS: Computed tomography scan detected the infiltrates as diffuse calcifications mainly at the lung bases. Extended arterial vascular calcifications were also found. Since approximately 4 years calcium-phosphorus product and parathyroid hormone had been increased. TREATMENT AND COURSE: Because of the long-term increased calcium-phosphorus product and the high parathyroid hormone levels we interpreted the pulmonary calcifications as a result of the tertiary hyperparathyroidism. After parathyroidectomy calcium-phosphorus product and PTH levels normalized, but our patient suffered from increasing disturbances of the peripheral blood circulation induced by the vascular calcifications, necessitating amputation of finger and toe tips. CONCLUSION: Patients with renal failure should undergo regular controls of calcium, phosphorus and parathyroid hormone when creatinine clearance is below 50 ml/min/1.73 m2. Only an early medical treatment can prevent the various complications induced by the secondary or tertiary hyperparathyroidism. If medical therapy fails, parathyroidectomy has to be done. Especially before renal transplantation the extent of hyperparathyroidism has to be carefully analyzed and treated aggressively, if necessary by surgery before the date of transplantation.

Calcinosis↗
PubMed2005

[Chlamydia pneumoniae--a new risk factor for calcific aortic stenosis?].

BACKGROUND: Nonrheumatic, calcific aortic stenosis is the main heart valve disease and the main cause of heart valve replacement in the elderly. Recent studies suggest that it is based on a chronic inflammatory process. The pathogenetic mechanisms, however, are unclear. METHODS: A MEDLINE search was conducted for the phrases "chlamydia pneumoniae" and "aortic valve", and all articles published between 1966 and May 2004 were evaluated. Data presented as letter or congress abstract was also included. RESULTS: Clinical and histopathologic studies demonstrate an association of calcific aortic stenosis and cardiovascular risk factors similar to atherosclerosis. As for atherosclerosis, infection with Chlamydia (C.) pneumoniae is also discussed as a further potential risk factor for calcific aortic stenosis. Previous seroepidemiologic and pathologic studies using various detection methods yielded heterogeneous results. CONCLUSION: Thus, data suggesting a pathogenetic association of C. pneumoniae and calcific aortic stenosis should be interpreted cautiously.

Antibodies, Bacterial↗
PubMed2003

[Operative treatment of extended peritendinous calcifications after open Achilles tendon repair-a case report].

In the recent literature, there are only a few hints on spontaneous or postoperative heterotopic ossifications of the Achilles tendon region. The strategies of treatment are different, both conservative and operative. Postoperative calcifications are not mentioned as typical complications in the treatment of Achilles tendon ruptures. We describe the case of a 39 year old male suffering of an increasing, painful swelling and a decrease of loading capacity. In clinical, sonographic and radiological investigations,we found large peritendinous calcifications ventral to the intact heel tendon up to 36 mm in diameter. After operative resection of the calcifications and postoperative chemical prophylaxis, the patient has been without pain for 1 year. There was no relapse of the calcifications or re-rupture of the tendon.

Achilles Tendon↗
PubMed2004

Vascular calcification and osteolysis in diabetic neuropathy-is RANK-L the missing link?

Diabetic neuropathy is associated with osteopenia and calcification of vascular smooth muscle cells. These changes are most marked in patients with acute neuropathic osteoarthropathy (Charcot foot), in which osteopenia is universal and the prevalence of vascular calcification exceeds 90%. While it has been thought that both osteopenia and vascular calcification may be linked to sympathetic denervation with increased peripheral limb perfusion, the cellular mechanism was not clear. However, the recent recognition that the receptor activator of nuclear factor kappa B ligand (RANK-L)/osteoprotegerin (OPG) signalling pathway is central to the processes regulating bone turnover in a wide variety of medical conditions has raised the possibility that the same cytokines may be involved in the osteolysis which accompanies diabetic neuropathy. This is made more likely by the realisation that the RANK-L/OPG pathway is also thought to mediate the calcification of vascular smooth muscle cells in coronary and peripheral vascular disease. The circumstantial evidence underpinning this hypothesis is reviewed here, and it is suggested that the unregulated activation of RANK-L-mediated effects on bone and arteries may be triggered by the loss of nerve-derived peptides, e.g. calcitonin gene-related peptide, which normally exert a moderating influence on the pathway.

Calcitonin Gene-Related Peptide↗
PubMed2006

Coronary calcification and osteoporosis in men and postmenopausal women are independent processes associated with aging.

The objective of this study was to investigate whether low bone mass is directly associated with the severity of coronary atherosclerosis in men and postmenopausal women self-referred for evaluation of coronary atherosclerosis and osteoporosis. Low bone mass was evaluated by measurement of bone mineral density (BMD) using quantitative computerized tomography (QCT). Coronary atherosclerosis was evaluated by measurement of coronary calcium (CC) burden using electron beam computerized tomography (EBCT). Using a cross-sectional design, we tested the hypothesis that osteoporosis and coronary atherosclerosis are correlated, age-dependent processes. Study variables were BMD, CC scores, and other known risk factors for osteoporosis and atherosclerosis. Qualifying for the study were 313 postmenopausal women and 167 men. Men had higher baseline CC scores and higher body mass indexes compared to women. In females, those patients with coronary calcification were older and had significantly lower BMD compared to those without calcification. In males, those patients with coronary calcification were older. By univariate correlation analysis, the degree of coronary calcification was inversely associated with BMD in postmenopausal women (P < 0.0001) but not in men. However, after controlling for age, this association was absent for both men and postmenopausal women. Using multivariate logistic regression analysis in women and men separately, age was the only significant predictor of positive CC status and low BMD. Our study suggests that in postmenopausal women and in men, after controlling for age, osteoporosis and coronary atherosclerosis are independent processes.

Aging↗
PubMed1996

The influence of aortic calcification on spinal bone mineral density in vitro.

We examined the influence of aortic calcification on the spine phantom bone mineral density (BMD). Soft X-ray photographs of human aortae were taken to calculate the percent calcification of aortic tissues. Human aorta laid on lumber spine phantom was placed in the bottom of 15 cm of water and BMD and bone mineral content (BMC) were measured in the anteroposterior view. Samples with severe aortic calcification (over 30%) caused a 2.5% increase of BMD. There might be a relatively small influence of aortic calcification on the value of L2-L4 BMD, but changes over time in a patient could falsely elevate values.

Absorptiometry, Photon↗
PubMedDate not supplied

Myocardial calcification caused by secondary hyperparathyroidism due to dietary deficiency of calcium and vitamin D.

A 6-year-old girl presented with respiratory distress. Chest radiographs exhibited calcifications in the mediastinum. Further imaging revealed extensive cardiac calcifications on computed tomography of the chest. The laboratory parameters were consistent with findings of secondary hyperparathyroidism. Detailed review of her dietary history revealed a prolonged history of dietary deficiency of calcium and vitamin D. Treatment consisted of adequate daily replacement of calcium and ergocalciferol. On follow-up, her parathyroid hormone level was significantly reduced and substantially reduced cardiac calcifications were seen on echocardiogram. Pediatric cardiologists must be aware of this potentially fatal but treatable disease in children with cardiac calcifications unexplained by other causes.

Calcinosis↗
PubMedDate not supplied

Fatal outcome of two siblings with idiopathic arterial calcification of infancy diagnosed in utero.

Idiopathic arterial calcification of infancy (IACI) is a rare condition characterized by extensive arterial calcification and stenoses of large and medium-sized arteries. Its complications include severe cardiac failure diagnosed in utero as hydrops fetalis or postnatally as respiratory failure combined with cardiomegaly. Two newborn male siblings with IACI are described. In utero, echocardiography revealed poor ventricular function and hyperechogenic foci in arterial walls. Both had fatal outcome during the newborn period. At autopsy, medial calcifications in the walls of great arteries, in coronary arteries, in glomeruli, and in subendocardium were detected. In addition, an inflammatory process in the shoulder joint was determined to be large periarticular tissue calcifications. Because of an autosomal recessive inheritance pattern of IACI, fetal echocardiography is recommended in future pregnancies of all affected families.

Calcinosis↗
PubMed2001

Renal venous thrombosis with calcification and preservation of renal function.

Two neonates were found on US to have branching linear calcification in the renal parenchyma, right sided in one and bilateral in the other. CT confirmed the presence of branching calcification in the kidneys and demonstrated calcified thrombus in the inferior vena cava in both babies. Antenatal detection of adrenal haemorrhage in one baby and presence of calcification at the age of 3 days in the other indicate that thrombosis probably occurred before birth. The kidneys remained normal in size, and uptake of 99mTc-labelled dimercaptosuccinic acid (99mTc-DMSA) was normal on follow-up examination. The presence of branching calcification and normal renal size probably indicates good prognosis for renal function in neonates in whom renal venous thrombosis is found and may indicate prenatal thrombosis.

Calcinosis↗
PubMedDate not supplied

Ductal adenocarcinoma of the pancreas with intratumoral calcification.

We present two cases of ductal adenocarcinoma of the pancreas with intratumoral calcification. The two cases indicate two different etiologies for intratumoral calcification in ductal adenocarcinoma. Thus, the possibility of adenocarcinoma should be considered when a tumor with intratumoral calcification is found, although the incidence of intratumoral calcification in the ductal adenocarcinoma of the pancreas remains rare.

Adenocarcinoma↗
PubMed2004

Calcific myonecrosis: a report of ten new cases with an emphasis on MR imaging.

The aim of this study is to report the typical radiographic and MR imaging features of calcific myonecrosis, which help to distinguish this rare entity from other causes of a calcifying calf mass. Ten patients with a final diagnosis of calcific myonecrosis were referred to a specialist orthopaedic oncology service in a 5-year period with the presumptive diagnosis of malignancy based on recent clinical presentation and imaging findings. Radiographs were available for retrospective review in all ten cases and MR imaging in six. All patients presented with a slow-growing painless calf mass. All gave a history of major trauma to the lower leg many years before, but in only two cases did the referring clinician query whether trauma might be a contributory factor. Radiographs showed well-defined fusiform mineralised masses up to 25 cm in length arising within the calf. The calcification was consistently peripheral and plaque-like. Ossification was not present. MR imaging showed the anterior compartment to be involved in four cases and all compartments in two. T1- and T2-weighted images showed peripheral low signal intensity, more prominent on the T2-weighted images, because of the peripheral mineralization. The contents of the masses were variable on T1-weighted images depending on the differing amounts of blood breakdown products and were heterogeneous on T2-weighted images. The latter may be explained by a combination of the mineralisation and T2 shortening due to blood breakdown products. A gadolinium chelate, administered in two cases, failed to show any appreciable enhancement. Calcific myonecrosis has characteristic clinical, radiographic and MR features that should make the condition easy to recognise. Despite its rarity, it should be included in the differential diagnosis of focal mineralisation of the calf.

Adult↗
PubMed1999

Calcific tendinitis of the gluteus maximus tendon: CT findings.

Two cases of calcific tendinitis of gluteus maximus muscle are presented. The CT findings, including amorphous calcification without soft tissue mass and possible cortical erosion at the femoral enthesis of the gluteus maximus muscle, are highly suggestive of calcific tendinitis at this unusual but classical location. Ossifying entheses with well-defined cortical defect are frequent at the femoral insertion of the gluteus maximus muscle in asymptomatic subjects and must be differentiated from a real cortical erosion sometimes associated with these calcific tendinitis.

Calcinosis↗
PubMed2002

[Sclerochoroidal calcification with subretinal membrane in a patient with high myopia].

BACKGROUND: Sclerochoroidal calcifications are rare and benign lesions. The diagnosis is made upon their fundoscopic and echographic appearance. Because of their possible association with diseases involving disturbances of calcium and phosphate metabolism, these parameters should be investigated as well. CASE REPORT: We present a patient with the classical features of sclerochoroidal calcifications. In fluorescein and indocyanine-green angiographies a presumed subretinal neovascular membrane was observed. CONCLUSION: The diagnosis of sclerochoroidal calcifications should be complemented with angiographic investigations because of a possible association with a subretinal neovascular membrane. In two such cases reported previously in the literature, the neovascular membrane was treated by laser coagulation. In one case, as in ours, no treatment was undertaken. The good prognosis of sclerochoroidal calcifications remained unaltered in all cases.

Adult↗
PubMed2003

[Detection of coronary calcifications by electron beam tomography and multislice spiral CT: clinical relevance].

Coronary calcifications can be detected and quantified using electron beam tomography (EBT) or newer generation multi-slice spiral CT (MSCT) scanners. An abundance of data has been acquired by EBT. It could be shown that the amount of coronary calcium correlates to the coronary plaque burden. The detection of coronary calcium with CT imaging methods therefore provides a unique opportunity to detect and quantify coronary atherosclerosis in a subclinical stage. Consequently, the presence and amount of coronary calcium has been shown to be indicative for an increased coronary event risk in symptomatic and asymptomatic individuals. Several clinical studies found a predictive value that was superior to conventional risk factors. Clinically, the use of coronary calcification assessment may therefore be beneficial in patients who, based on traditional risk factors, seem to be at "intermediate risk" for coronary events (10-year event risk 10-20%) in order to decide on the aggressiveness of risk factor modification. The role of coronary calcium quantification to monitor the progression of disease has not been clarified yet. Large, ongoing trials will provide further data as to the relative merit of coronary calcium assessment for risk stratification and will help to more clearly define its clinical role. The relationship between coronary calcium and coronary stenoses is more complex. While the absence of coronary calcifications makes significant coronary stenoses unlikely, even large amounts of coronary calcium do not necessarily indicate the presence of coronary artery stenoses. Pronounced coronary calcifications as an isolated finding should therefore not be the motivation for invasive diagnostic procedures in the absence of other evidence of ischemic heart disease.

Calcinosis↗
PubMed2004

Expression and activity of matrix metalloproteinase-2 in calcific aortic stenosis.

Calcific aortic stenosis is the main heart valve disease in the elderly, leading to massive focal calcification and thickening of the valve cusps. Matrix metalloproteinases (MMPs) are thought to contribute to this process. Therefore, the study assessed the expression of the gelatinases MMP-2 and MMP-9 and the endogenous tissue inhibitor of metalloproteinase (TIMP)-2 as well as the gelatinolytic activity in normal and stenotic valves. Human tricuspid aortic valves with and without calcific aortic stenosis were studied by immunohistochemistry for MMP-2, MMP-9 and TIMP-2. The gelatinolytic activity in native valve sections was assessed by gelatin in situ zymography with or without addition of the MMP activator p-aminophenymercuric acetate (APMA). Staining intensities for MMP-2 and TIMP-2 were elevated in stenotic valves as compared to controls. Minor staining of MMP-9 was present exclusively in stenotic valves. The morphologic distribution of gelatinolytic activity was comparable to the staining pattern of MMP-2, and since MMP-9 immunostaining demonstrated only a low number of positive cells, the observed gelatinolytic activity is likely due to MMP-2. Gelatinolytic activity was low in normal valves but significantly increased by the MMP activator APMA. In contrast, stenotic valves showed a strong basal gelatinolytic activity that could not be significantly enhanced by APMA suggesting that MMP-2 is present as a latent pro-enzyme in normal valves and activated in stenotic valves. Thus, MMP-2 might be involved in the matrix remodeling during calcific aortic stenosis.

Aortic Valve↗
PubMed2002

Morbus Teutschländer - a massive soft-tissue calcification of the foot in a patient on long-term hemodialysis.

Morbus Teutschländer is a benign metabolic disorder involving soft-tissue masses near large joints and a rarely observed form of extraskeletal calcifications. For example, it is seen in patients with chronic renal failure, but in most cases it remains clinically silent. In a minority of patients, this soft-tissue calcification is responsible for complications. Various locations of calcium deposits have been characterized. Advanced age and increased calcium x phosphate product are some of the underlying reasons, but local factors are involved as well. Prevention should be preferred because the treatment is generally difficult. We describe the case of a morbus Teutschländer in a 58-year-old woman with chronic renal failure on hemodialysis presenting with a massive soft-tissue calcification of the foot with a compression of a cutaneous nerve secondary due to uremic tumoral calcinosis. The tumoral masses was successfully excised, and at the 1-year follow-up, the patient had no discomfort. Clinical and radiological features and treatment are discussed, and a review of soft-tissue calcifications is given.

Calcinosis↗
PubMed2005

Matrix Gla protein and osteopontin genetic associations with coronary artery calcification and bone density: the CARDIA study.

A role for matrix proteins has previously been proposed in the pathogenesis of arterial calcification in the setting of atherosclerosis, and a link has been suggested between osteoporosis and arterial calcification. Our aim has been to investigate whether matrix Gla protein (MGP) T-138C, osteopontin (SPP1) T-443C, and Asp94Asp single nucleotide polymorphisms are associated with the development of arterial calcification and bone density. The individual effects of the MGP and SPP1 polymorphisms with coronary calcification are weak and not statistically significant. Bone mineral density differences at both the hip and spine do not vary statistically by genotype for any of the polymorphisms studied. Given the significant role of both MGP and SPP1 in arteriosclerosis, further research in higher risk, older populations are needed to determine fully the way in which MGP and SPP1 polymorphisms are associated with disease.

Black People↗
PubMed2004

"Missing" inhibitors of calcification: general aspects and implications in renal failure.

In the recent past, it has become increasingly clear that extracellular calcium and phosphate homeostasis is a tightly regulated process. Since the physiological serum concentrations of calcium and phosphate are several orders of magnitude above their solubility product, mechanisms inhibiting precipitation must be operative to prevent extraosseous calcification. A number of local and systemic calcification inhibitors, including fetuin-A, matrix Gla protein, and osteoprotegerin, have been identified in recent years. Deficiency and dysregulation of such factors may contribute to morbidity and even mortality. Extraosseous calcifications occur with high prevalence in patients with end-stage renal disease. In particular, vascular manifestations are clearly associated with cardiovascular events and decreased survival. In addition to the well-established roles of hyperphosphatemia and an increased calcium x phosphate product, the biological and potential clinical roles of disturbances in calcification inhibition in uremia are discussed in this overview.

Blood Proteins↗