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PubMedDate not supplied

Relationship between serum magnesium, parathyroid hormone, and vascular calcification in patients on dialysis: a literature review.

Secondary hyperparathyroidism is present in most patients with end-stage renal disease and has been linked to uremic bone disease, vascular calcification, and mortality. Current literature suggests an association between hypomagnesemia and cardiovascular disease in the general population. We reviewed all published studies on the relationship between serum magnesium and parathyroid hormone and the relationship between serum Mg and vascular calcification in dialysis patients. Of these, 10 of 12 studies of patients on hemodialysis and 4 of 5 studies of patients on peritoneal dialysis showed a significantinverse relationship between serum Mg and serum intact parathyroid hormone. Hyperparathyroidism develops in peritoneal dialysis patients dialyzed with a solution containing normal calcium (1.25 mmol/L) and low Mg (0.25 mmol/L), even though serum calcium is maintained at a normal level. Four of the hemodialysis studies and one of the peritoneal dialysis studies indicated that there is an inverse relationship between serum Mg and vascular calcification in these patients. Potential benefits have been attributed to magnesium carbonate as a phosphate binder and it may possibly be an effective, less toxic, less expensive phosphate binder. We believe that the role of Mg in secondary hyperparathyroidism and vascular calcification merits further investigation.

Calcinosis↗
PubMed2006

Successful treatment of soft tissue calcifications in uremia.

The appearance of soft tissue calcifications in patients with chronic renal failure has been recognised as one of the serious complications of uremia. An elevated serum calcium-phosphate product has almost invariably been detected, although the exact mechanisms of precipitation are still not fully understood. Among the factors responsible for triggering the precipitation process are: hyperphosphatemia, secondary hyperparathyroidism, hypercalcemia, treatment with vitamin D3, etc. Phosphate binders have been used to prevent, among other things, soft tissue calcifications, and parathyroidectomy has most frequently been applied as the therapy of choice, once precipitation of calcium salts has occurred. We present a case of soft tissue calcifications in the gluteal regions of a chronic haemodialysis female patient. The therapy we chose was a combination of biphosphonate and deferoxamine. The patient was treated for two months. The regression of the soft tissue calcifications was very significant, as registered both clinically and radiologically. The exact mechanism by which this reversal was achieved needs further investigation.

Buttocks↗
PubMedDate not supplied

Secondary cervical dystonia in iatrogenic hypoparathyroidism associated with extensive brain calcifications.

Cervical dystonia (CD) is usually idiopathic, without a known aetiology. Hypoparathyroidism, both primary and secondary, can be associated with brain calcifications and various clinical neurological features. Anecdotal evidence suggests that patients affected by hypoparathyroidism show a rapid-onset oral dyskinesia after use of neuroleptic drugs. We report the case of a 60-year-old woman with CD, iatrogenic hypoparathyroidism and extensive brain calcifications. On the basis of the clinical features and the localization of the brain calcifications we suppose that they may have played a role in the development of this CD. This case may prove to be, after a review of literature, the first report of CD secondary to iatrogenic hypoparathyroidism in a patient with extensive brain calcifications.

Brain Diseases↗
PubMed1992

Sclerochoroidal calcification.

We studied 19 patients with sclerochoroidal calcification. The findings were bilateral in 16 patients and unilateral in the remaining three patients. The lesions, which were usually multifocal, had two characteristic appearances, plaque-like and tumorlike. Eleven patients had relatively flat, irregularly shaped, plaque-like, yellow-white lesions located between the arcades and the equator. Eight patients had more elevated tumorlike lesions, ranging up to 6 mm in height. All showed patterns on echography consistent with calcification. The calcification was often documented in both the choroid and sclera; sometimes it appeared only in the choroid, but never only in the sclera. Calcium metabolism appeared to be normal in all but two of the nine patients in whom it was investigated. Idiopathic sclerochoroidal calcification has a characteristic echographic and ophthalmoscopic appearance and may be more common than has been realized.

Aged↗
PubMed1991

[Evaluation of coronary artery calcification by ultrafast CT].

A preliminary study was performed to determine whether ultrafast computed tomography (UFCT) is useful as a noninvasive screening examination for predicting coronary artery disease (CAD). UFCT was used to detect coronary artery calcification in 31 patients with angina pectoris (AP) without myocardial infarction. Except for six patients with vasospastic AP, 22 out of 25 patients had detectable calcification in at least one vessel. SVD, DVD and TVD were detected in six of nine patients (67%), seven of seven (100%) and nine of nine (100%), respectively. Based on the findings of coronary calcification by UFCT, the sensitivity, specificity and predictive accuracy of angiographically significant stenosis (greater than 75%) were 94%, 71% and 78% for all branches, respectively. The calcification score for vessels with significant stenotic lesion (n = 48) was statistically higher (p less than 0.01) than that for vessels without stenotic lesion (n = 45). In conclusion, UFCT appears to be useful noninvasive screening examination for detecting CAD, although a prospective study in a large number of patients will be necessary to establish the value of this new method more reliably.

Aged↗
PubMed1991

[A case of renal artery aneurysm with calcification].

We report a case of left renal artery aneurysm with ring-like calcification in a 57-year-old man. The selective renal arteriography showed a 30 x 28 mm saccular type aneurysm arising from the periphery of the bifurcation of posterior segment artery. There were no clinical symptoms, such as hypertension and loin pain, but we performed aneurysmectomy for fear of rupture. Histopathological findings showed atherosclerotic changes with marked calcification of wall lacking natural collagen fibers. Renal artery aneurysm with calcification seldom ruptures because of its generally hard wall. However, as cases of rupture through weakness of calcification have been reported, we recommend positive surgical treatment.

Aneurysm↗
PubMed1991

Pseudohypoparathyroidism and cerebrovascular disease with dural calcification.

A 53-year-old woman is reported with recurrent cerebrovascular disease, pseudohypoparathyroidism and dural calcification without basal ganglia calcification. She had typical clinical and laboratory features of pseudohypoparathyroidism and a family history of the condition. One case has been reported previously with pseudohypoparathyroidism and Parkinson's disease without basal ganglia calcification. Patients with widespread intracranial calcification should be evaluated for underlying abnormalities in calcium metabolism. Calcium supplementation and administration of vitamin D frequently correct the metabolic abnormality and halt clinical progression.

Brain↗
PubMed1990

[The question of reversibility of tissue calcification in enzootic calcinosis of cattle and in experimental hypervitaminosis D].

In rabbits calcinosis was induced experimentally by feeding of Trisetum flavescens or Vitamin D3 injections. Calcifications in kidneys and lungs were proved by biopsies and x-ray examination respectively. Histological examination at intervals up to 26 months following the calcinogenic insult indicated signs of limited reversibility of calcification in lung, kidney and aortic wall. The degree of resorption of calcified deposits apparently was dependent on dosage, time and kind of tissue affected. Aortic wall and tendons had the least tendency to demineralisation and developed focal cartilage metaplasia. Two cows with proven enzootic Trisetum-calcinosis were kept under altered conditions for 31 and 32 months. At slaughter besides severe calcification and cartilage or osseous metaplasia in soft tissues a limited reabsorption of the calcifications could be observed. There were focal fibrous scars in the aortic wall.

Animals↗
PubMed1990

Calcification in oligodendroglioma.

Forty-four previously diagnosed surgical biopsy specimens of oligodendroglioma with calcification from the file of Veterans General Hospital-Taipei between 1977-1985 form the base of this study. Thirty-two patients (72.8%) had varied degree of calcification deposits in tumor parenchyma related to blood vessels while 12 patients (27.2%) in tumor parenchyma unrelated to blood vessels. Ten patients (22.7%) disclosed calcification at the vicinity of tumor tissue. Histochemical studies of the calcified deposits revealed no trace minerals other than calcium and iron. Electron microscopic examination of the calculi showed membrane-bound vesicles and radially precipitated crystals that simulated hydroxyapatite of psammoma body in meningioma. There was no statistically significant correlation between the demise or recurrence of patients and the calcification of tumor when Chi-squared test was applied.

Brain Neoplasms↗
PubMed1990

Calcifications of the breast after reduction mammoplasty.

Mammograms of 152 patients after mammoplasty were studied and 37 patients were noted to have calcifications. The pattern of these calcifications was studied to determine if specific characteristics could be identified. The calcifications were found to occur within the skin of the breast, mainly at a periareolar location. The ability to identify these benign calcifications further aids in reliably monitoring patients by mammography after reduction mammoplasty.

Adult↗
PubMedDate not supplied

Biomaterial calcification without direct material-cell interaction.

This report summarizes 1) features of the local redistribution of calcium ions and formation of complexes with calcium (Ca) in the presence of polymer samples; 2) the adsorption of Ca ions and Ca containing complexes onto biomaterial surfaces; 3) the character and composition of Ca containing deposits; and 4) the role of cellular and humoral factors in calcification. All experiments were done with three types of medical grade polymer material (from USSR): silicone rubber (SR), polyurethane "Vitur" (PU), and polyethylene (PE). Biochemical, radioisotopic, SEM, and EDAX methods were used in in vitro and in vivo experiments. The diffusion chamber model was used in animal experiments. SR was shown to induce greater changes in complex formation processes and to adsorb more Ca containing complexes than PE or PU. In addition to the degree of SR calcification seen after 21 days, implantation accentuated these findings. The possibility of calcification of polymer materials without direct contact of material and cells was observed. Combining the in vitro and in vivo experimental data, the authors propose a hypothetical scheme of biomaterial calcification.

Adsorption↗
PubMed1989

[Calcifications of the prostate: a transrectal echographic study].

Prostatic lithiasis is a well know phenomenon. It has little clinical significance and is not easily shown by conventional radiography, which has poor sensitivity and specificity. The authors have studied 612 patients with both suprapubic and transrectal US in order to 1) assess US sensitivity and specificity and 2) report the frequency, spatial distribution, number and features of prostatic calcifications with special emphasis on differential diagnosis between prostatic neoplasms and chronic prostatitis. The authors have also studied the relationship between morphology and symptoms and the results agree with those reported in the scanty literature. The authors conclude that the parameters studied are directly related to age, except for a younger group with clear evidence of genital inflammation. The authors emphasize the impossibility to correlate morphology of prostatic calcifications with pathologic conditions: there are no specific symptoms clearly connected with calcification even though the inflammation is often associated with calcifications.

Calcinosis↗
PubMed1989

Prevention of osteitis fibrosa, aluminium bone disease and soft-tissue calcification in dialysis patients: a long-term comparison of moderate doses of oral calcium +/- Mg(OH)2 vs Al(OH)3 +/- 1 alpha OH vitamin D3.

Since 1980, moderately large doses of oral calcium (80 +/- 35 mmol/day as CaCO3 +/- calcium polystyrene sulphonate), in association if necessary with Mg(OH)2 (2.5 +/- 1 g/day), with a reduction in the dialysate Mg concentrations from 0.75 to 0.375 mmol/24 h, have replaced A1(OH)3 as phosphate binders in our centre. A1(OH)3 was previously given to our haemodialysis patients in association with small doses of Ca CO3 (less than or equal to 3 g/day) and if necessary with 1 alpha OH vitamin D3. To compare the long-term efficacy of this new approach with the former one in the prevention of renal osteodystrophy and soft-tissue calcification, 32 current patients were selected on the basis of at least 24 months of treatment in our centre and availability of a yearly bone survey (profile of lumbar spine and anteroposterior view of the pelvis, shoulders and hands). A group of 30 patients treated before 1980 were then selected on the same criteria and matched for age, sex, and duration on dialysis. Linear calcifications of the anterior and posterior walls of the aorta in front of L2, L3, L4 and on the lateral walls of the iliac and femoral arteries were measured and the para-articular calcifications and subperiosteal resorptions of the hands evaluated. The initial extent and the subsequent increase of the ocular and para-articular calcification were comparable in the two groups. Plasma alkaline phosphatase was stable in the normal range in both groups, as was plasma concentration of calcium. Plasma phosphate was slightly elevated (1.7 mmol/l) but stable and comparable in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMedDate not supplied

Calcifications in the breast in Filaria loa infection.

A 40-year-old patient underwent mammography for evaluation of a mass. Atypical calcifications were observed in the opposite breast. Two types of calcification were observed: one type was spiral-shaped and the other type rod-shaped. These calcifications were caused by Filaria loa. Parasitic calcifications in the breast are uncommon.

Adult↗
PubMedDate not supplied

Tracheobronchial calcification in members of a fixed population sample.

In a review of the chest radiographs of 1152 consecutively examined subjects, 10 cases (0.87%) of extensive tracheobronchial calcification were identified. In addition, 51 subjects having this coded diagnosis were identified among 11,758 members of a fixed population sample. Sixty of these 61 subjects were women. Tracheobronchial calcification usually appeared after the age of 60. The subjects' clinical and other radiologic diagnoses were reviewed and tracheobronchial calcification appeared to have no clinical significance. Histologic findings in autopsied cases showed the calcifications and ossifications to be in the cartilaginous rings themselves. However, the reason for the overwhelming prevalence of this entity in women remains to be resolved.

Adolescent↗
PubMed1989

[Myocardial calcification in chronic renal failure].

The authors present the case of a young man who--as a consequence of chronic renal failure and long-term dialysis--developed a calcific cardiopathy. The myocardial calcification was proved histologically by light microscopy. They established that the calcification started in damaged myofibers and was principally caused by the secondary parathyroid hyperfunction. The diagnosis and therapy of the myocardial calcification is discussed on the basis of references. The prevention of this complication may improve the life-expectancy of patients treated by chronic dialysis.

Adult↗
PubMedDate not supplied

The effect of potassium phosphate, magnesium chloride and T6 as blocking reagents on tissue valve calcification.

Potassium phosphate, Magnesium chloride and T6 as blocking agents on tissue valve calcification have been studied in vitro and in vivo. In vitro tests indicate that untreated leaflets (control group) tend to calcify significantly more than treated leaflets (p less than 0.05). Calcification in the treated leaflets tends to be varied with no significant difference (p greater than 0.05) between the different groups. In vivo findings indicate that leaflets in the control group calcify as early as 5 weeks after implantation while treated leaflets showed no significant signs of calcification at this stage. Results deduced from the extractable calcium contents as well as from histological examination, emphasise the need of a blocking reagent to decrease calcification on a valvular bioprosthesis.

Animals↗
PubMed1988

[Conjunctival calcification in patients in chronic hemodialysis. Morphologic, clinical and epidemiologic study].

The authors compared the presence of conjunctival calcifications in a group of 37 patients undergoing chronic hemodialysis with laboratory findings and radiologic examinations. These calcifications appear to develop in patients suffering from hypercalcemia, particularly when the mathematical product of inorganic calcium and phosphorus (Ca x PO4) exceeds the value of 3.8-4.0. Ocular calcifications are usually asymptomatic although conjunctival inflammation due to crystal deposition, better known as "red eyes", has been reported in uremic patients. This has been noted to improve after the Ca x PO4 product is reduced. Such a conjunctival inflammation has not been reported in patients undergoing chronic hemodialysis and we do not report any case of disturbance due to the presence of conjunctival lesions. These lesions usually occur in the paralimbal conjunctiva, in the limbal area exposed by the interpalpebral fissure. This is thought to be due to the relatively high alkalinity, resulting from the diffusion of CO2 from the exposed surface of the eye, which promotes the deposition of calcium salts. However, the frequent presence of pinguecula, or histologic elastosis, in the eyes of uremic patients with calcifications, suggests a pathogenic role of local degenerative changes as well. Among these 37 patients, 6 underwent a biopsy of the conjunctival lesions, allowing a pathological examination. This permitted the authors to confirm the presence of calcium deposits in the basal lamina of the conjunctival epithelium and also in the sub-epithelial tissue. In every case, a significant degeneration of the elastic tissue of the conjunctiva was found, confirming that this lesion can precede calcium deposition in these particular patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗