Presentation
We believe this is the first presentation in the literature of Mönckeberg medial calcinosis visualized in the infraorbital arteries. [ncbi.nlm.nih.gov]
Lab values at presentation included normal electrolytes, including calcium (9.2 mg/dl) and phosphorus (4.5 mg/dl), with HgA1C of 13%. [woundsresearch.com]
It can progress to painful and disabling conditions, and can become infected, especially when skin ulceration is present. Objective: To present a case of calcinosis in the inguinal region and its surgical recovery. [rbcp.org.br]
Entire Body System
- Weakness
It is an autoimmune disease characterized by a systemic vasculopathy with myositis, progressive muscle weakness and dermatological findings. [elsevier.es]
We report on a 19-year-old boy with hereditary multiple exostoses (HME) who presented several months history of progressive weakness of his left hand and left lower limb. [semanticscholar.org]
The systemic evaluations including the neurological examination were normal, and the patient had no symptoms such as muscle weakness or stiffness. [jcasonline.com]
Additional clinical investigation showed that the patient had a history of dyspnoea, generalized weakness, arthralgia and gastro-oesophageal reflux disease. [birpublications.org]
In clinical image: general weakness, loss of appetite, vomitting, nausea, weight loss, osallgies, myalgies, periodical polydypsia-polyurea, partial tetany. Muscular weakness and myalgies are conditioned by progressive atrophy of muscles. [mafiadoc.com]
- Fatigue
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 13, 2019 [patientslikeme.com]
It usually presents <20 years of age, and is more common in women. palpable calcific plaques in subcutaneous or deeper tissue fatigue, muscle pain, and stiffness possible high levels of γ-carboxyglutamic acid in tissues and urine ~1/3 of cases are associated [radiopaedia.org]
He reported bilateral shoulder and right hip pain for one year, associated with appetite loss, general fatigue, and systemic high fever. He was on oral CaCO 3 1.5 g/day. [sjkdt.org]
The lesions may be accompanied by other symptoms, such as fatigue and weakness. [healthline.com]
- Anorexia
Due to the general fatigue, anorexia, fever of unknown origin and inflammatory syndrome, and considering the endemic state of TB in our country and the protein rich ascites effluent with high lymphocyte count, tuberculosis peritonitis was suspected. [sjkdt.org]
[…] calcinosis) Hypervitaminosis D Skin/subcutaneous calcinosis Low blood 1,25D levels Normal or low blood phosphorus Elevated blood calcium & renal calcium excretion Elevated 25-OH vitamin D Symptoms of hypercalcemia incl polyuria, polydipsia, confusion, anorexia [ncbi.nlm.nih.gov]
- Anemia
In general image of blood anemia, eosinophilia, neutropenia occur. After urine analysis- isohypostenuria, proteinuria, cylindruria, micro hematuria. When there is an acute or chronic failure of kidneys-appropriate indexes of nitrogen metabolism. [mafiadoc.com]
Two others experienced increased fatigue, inflammation-mediated anemia of chronic disease, and thrombocytosis; one also had intermittent fevers and a cutaneous inflammatory calcific reaction [ Ramnitz et al 2016 ]. [ncbi.nlm.nih.gov]
- Pathologist
As a derma- pathologist, I am also pleased that this project has been organized and undertaken by two distinguished authorities in cutaneous pathology. [books.google.com]
[…] hernia, which delays the correct diagnosis, as in our case. 7, 9 In addition, when other diagnoses are clinically suspected and these calcified lesions are biopsied, they are often non-confirmatory owing to a misinterpretation of the biopsied tissues by pathologists [birpublications.org]
Gastrointestinal
- Constipation
Patients with gastrointestinal involvement may present with difficulty chewing, dysphagia, esophageal strictures, GERD, delayed gastric emptying, and general dysmotility of the small and large bowel, leading to bloating/ abdominal distention and diarrhea/constipation [appliedradiology.com]
The storm is before handed by symptomatic of hyperparathyreosis: weakness, adynamy, dyspeptic disorders-nausea, vomiting, constipation, lack of appetite. [mafiadoc.com]
- Loss of Appetite
In clinical image: general weakness, loss of appetite, vomitting, nausea, weight loss, osallgies, myalgies, periodical polydypsia-polyurea, partial tetany. Muscular weakness and myalgies are conditioned by progressive atrophy of muscles. [mafiadoc.com]
Cardiovascular
- Hypertension
In fact, due to new onset of pulmonary hypertension in the authors’ patient, the treatment with dasatinib had to be stopped. [woundsresearch.com]
Mousse calcinosis was associated with pulmonary arterial hypertension, the stone subset was suggestive of pulmonary involvement and justified further investigation and the net subset was the slowest to heal. Conclusion. [academic.oup.com]
Mousse calcinosis was associated with pulmonary arterial hypertension, the stone subset was suggestive of pulmonary involvement and justified further investigation and the net subset was the slowest to heal. [ncbi.nlm.nih.gov]
Musculoskeletal
- Osteoporosis
Our data confirm a strong association of calcinosis with digital ulcers, and support a novel association with osteoporosis. Copyright © 2016 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]
Calcinosis Working Group Update Past projects: * Multicenter retrospective study of 5218 patients * Prevalence of calcinosis 25% * Strong association of calcinosis with digital ulcers (OR=3.7) and osteoporosis (OR=3.9) * New radiographic scoring system [sites.bu.edu]
[…] calcinosis include the following: Colchicine – An anti-inflammatory drug to prevent pain and inflammation Diltiazem – A calcium channel blocker to prevent the influx of calcium into cells Corticosteroids – To reduce inflammation Bisphosphonates – To prevent osteoporosis [medindia.net]
Calcinosis was common in both limited and diffuse systemic sclerosis; both longer disease duration and osteoporosis were independently associated with calcinosis. PubMed, Mod Rheumatol, 2017 Jul 19:1-5. [sclero.org]
- Muscle Weakness
The systemic evaluations including the neurological examination were normal, and the patient had no symptoms such as muscle weakness or stiffness. [jcasonline.com]
She was pale, had muscle weakness, was tender around most joints and demonstrated evidence of healed vasculitic lesions on both hands and feet. Ulcers were noted on her thighs. The rest of the physical examination was within normal limits. [sajr.org.za]
It is an autoimmune disease characterized by a systemic vasculopathy with myositis, progressive muscle weakness and dermatological findings. [elsevier.es]
Classification–Disease activity When asked to characterize “active JDM disease”, nearly all respondents reported the presence of skin and muscle disease (defined as presence of rash, nail fold capillary changes, muscle weakness, elevation of muscle enzymes [ped-rheum.biomedcentral.com]
It can be triggered by trauma and/or chronic inflammation,12,14-31 such as in cases nonresponsive to corticotherapy, in the presence of generalized cutaneous vasculitis, important muscle weakness, and persistent elevation in muscle enzymes.4-6,13-15 The [scielo.br]
- Fracture
We report the case of a 27-year-old patient admitted for chronic hypercalcemia with right femur fracture and renal failure. [panafrican-med-journal.com]
Association of GALNT3 gene polymorphisms with bone mineral density in Chinese postmenopausal women: the Peking Vertebral Fracture study. Menopause, 21 (2014), pp. 515-521 [9] R.E. Slavin, J. Wen, D. Kumar, E.B. Evans. Familial tumoral calcinosis. [revistanefrologia.com]
Skin
- Calcinosis Cutis
What causes calcinosis cutis? Calcinosis cutis is classified into four major types. Dystrophic calcinosis cutis Dystrophic calcinosis cutis occurs in an area where there is damaged, inflamed, neoplastic or necrotic skin. [dermnetnz.org]
calcinosis cutis in patients with CML. [woundsresearch.com]
These include calcinosis cutis circumscripta, calcinosis cutis universalis, tumoral calcinosis, and transplant-associated calcinosis cutis [6]. [hindawi.com]
These include calcinosis cutis circumscripta, calcinosis cutis universalis, tumoral calcinosis, and transplant-associated calcinosis cutis. [1] Calcifications occur in a variety of other clinical settings. [jcytol.org]
Keywords: Calcinosis Cutis, calcium Gluconate, Neonate Introduction Calcinosis cutis involves deposition of calcium salts in skin and subcutaneous tissue. [bjmp.org]
- Pruritus
Scrotal sac reconstruction may be required in extensive and severe diseases. 16 The indications for surgical excision include cosmetic concerns, severe pruritus, and ulceration. 16 The second patient, who was slightly older, single, and was educated to [dovepress.com]
Initially, the tissue fibrosis begins with an edematous phase, which is the active inflammatory phase, associated with erythema, pruritus, and nonpitting edema. [appliedradiology.com]
Neurologic
- Headache
Severe headache complicated by vertical atlantoaxial subluxation in diffuse systemic sclerosis with crowned dens pattern calcification. Rheumatol Int 2011; 31, pp 1247–1250. [nature.com]
- Dizziness
Dizziness is particularly associated with the lipophilic tetracyclines (for example, minocycline, doxycycline). [ard.bmj.com]
Urogenital
- Renal Insufficiency
However, their use in renal insufficiency may result in toxicity. Sodium etidronate and bisphosphonates may be helpful in some individuals by reducing the bone turnover and inhibiting the growth of ectopic hydroxyapatite crystals. [hindawi.com]
Aluminum hydroxide antacids may be effective phosphate binders in patients with hyperphosphatemia, but their use in renal insufficiency may result in toxicity [ 3 ]. [karger.com]
It is recommended that patients be evaluated for abnormalities of calcium and phosphorus metabolism and that they be assessed for associated systemic conditions, such as collagen vascular diseases, renal insufficiency, and vitamin D poisoning. [bjmp.org]
Workup
A hormonal workup, including calcitonin, parathyroid hormone, and thyroid hormone levels, was also within normal limits. [karger.com]
Laboratory workup revealed normal blood counts, serum calcium, phosphorous, and alkaline phosphate levels. [jcnonweb.com]
Conclusion After clinical diagnosis of calcinosis cutis, a laboratory workup to rule out abnormalities of calcium and phosphorus metabolism, malignant processes, collagen vascular diseases, renal insufficiency, excessive milk ingestion, and vitamin D [hindawi.com]
X-Ray
- Soft Tissue Calcification
Figure 1 X‐ray of right elbow: soft‐tissue calcification throughout the elbow and forearm. Calcinosis universalis is soft‐tissue calcification presenting as a complication of JDM. It is often detected in childhood in 30% to 70% of patients. [journalofhospitalmedicine.com]
Soft tissue calcifications may be easily demonstrated on plain radiographs, but CT scan is more effective in demonstrating the location and extent of calcifications. [sajr.org.za]
Click here to view Figure 2: Elbow X-ray: soft tissue calcification and vascular calcification. Click here to view Figure 3: a and b: Hands and knee X-ray showing vascular calcifications. [sjkdt.org]
Radiographically, idiopathic tumoral calcinosis demonstrates lobulated, cloudy soft-tissue calcifications near a joint (A). [jaocr.org]
[…] previous soft tissue calcification. [archivesofpathology.org]
- Muscle Calcification
Pathology: Calcinosis may affect the skin, subcutaneous layers including the fascia and muscle. Calcific lesions are rich in hydroxyapatite but may also contain calcium oxalate and uric acid in crystalline form. [rheumaknowledgy.com]
Computed tomography (CT) scan showing calcifications in an adult with HFTC including shoulder and hip soft tissue calcifications (white arrows), aortic calcification (dashed arrow), papillary muscle calcification (black arrow), and submucosal gut calcifications [ncbi.nlm.nih.gov]
Treatment
Systemic tetracycline in the treatment of non-infected corneal ulcers. Ann Opthalmol1985;17:742–4. ↵ Berk MA, Lorincz AL. The treatment of bullous phemphigoid with tetracycline and niacinamide. [ard.bmj.com]
Study treatment will be 16 g/m2 sodium thiosulfate administered 3 times weekly over a period of 10 weeks at the NIH. Subjects who complete 10 weeks of treatment or reach the primary end point by week 6 will be considered completers. [clinicaltrials.gov]
Experienced physicians are more likely to use non-immunosuppressive treatments. [ncbi.nlm.nih.gov]
The best treatment for calcinosis cutis is still unclear, as no fully effective treatment is available. We attempted clinical drug treatment to stop or slow disease progression. [rbcp.org.br]
Treatment Treatment of dystrophic calcification is varied. Numerous drugs, hormones, and a host of non-specific measures have been used unsuccessfully in the treatment of calcinosis. [healthcentral.com]
Prognosis
Prognosis The prognosis of CREST syndrome is relatively good with a long-lasting disease duration (>10 years). However, pulmonary arterial hypertension may be a complication of the disease and may lead to a more severe prognosis. [orpha.net]
Treatment and prognosis No established therapy is recognized, but calcium chelates (EDTA) bisphosphonates, and steroids have been used with little consistent benefit. [radiopaedia.org]
EXPERT ANALYSIS FROM A SYMPOSIUM SPONSORED BY THE AMERICAN COLLEGE OF RHEUMATOLOGY CHICAGO – The prognosis for adults diagnosed with calcinosis remains grim, despite some excellent treatment responses reported in children for this often disabling and [mdedge.com]
Medicinos akademija Date: 2015 Note: Apginta: 2015-08-31 Autoriaus publikacijos disertacijos tema: p. 25-27 Keywords: Coronary artery disease;complications;Vascular calcification;genetics;Coronary thrombosis;genetics;Prognosis Abstract: Darbo tikslas [lsmuni.lt]
Prognosis : Lesions tend to be chronic and less commonly are relapsing or remittent. Calciphylaxis has a significant mortality rate of 60% to 80%. BIBLIOGRAPHY Khafif RA, DeLima C, Silverberg A, et al. Calciphylaxis and systemic calcinosis. [rheumaknowledgy.com]
Etiology
Several classifications based on the etiology, the location of brain calcifications and the clinical presentation have been proposed. [ncbi.nlm.nih.gov]
It is classified into 4 major types according to etiology: dystrophic, metastatic, iatrogenic, and idiopathic. [ajnr.org]
Abstract Calcinosis universalis is a rare and interesting condition of unknown etiology characterized by deposits of calcium in the skin and subcutaneous tissues. The diagnosis is easily made roentgenographically. [pubs.rsna.org]
Epidemiology
PURPOSE OF REVIEW: This article reviews the most updated literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). [ncbi.nlm.nih.gov]
Summary Epidemiology The prevalence is estimated at about 1/12,500 adults. Women are predominantly affected (F/M sex ratio around 4:1). Clinical description The disease usually manifests at between 40 and 50 years of age. [orpha.net]
This article reviews the most updated literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). PubMed, Curr Opin Rheumatol, 2015 Nov;27(6):542–8. [sclero.org]
Smoller, Franco Rongioletti, 2010 4 The imaging of tropical diseases: with epidemiological, ... LaPorta GA et al: Tumoral calcinosis of the foot. [educalingo.com]
Epidemiologically, most ISC presentations occur in the third to fourth decade of life, following years of insidious onset without any systemic disorder of the calcium/phosphorus metabolism. 1 To the best of our knowledge, 10 cases of ISC have been reported [dovepress.com]
Pathophysiology
Fibroblast growth factor 23 and Klotho: physiology and pathophysiology of an endocrine network of mineral metabolism. Annu Rev Physiol, 75 (2013), pp. 503-533 [5] C. Bergwitz, H. Jüppner. [revistanefrologia.com]
PURPOSE OF REVIEW: This article reviews the most updated literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). [ncbi.nlm.nih.gov]
The pathophysiology of calcinosis cutis is not well understood, and there is a broad range of severity seen, from benign localized, small nodules to large, severely debilitating lesions (2). [clinicaltrials.gov]
(Also see Bone Resorption ) Calcinosis: pathophysiology and management. [sclero.org]
Prevention
[…] pain and inflammation Diltiazem – A calcium channel blocker to prevent the influx of calcium into cells Corticosteroids – To reduce inflammation Bisphosphonates – To prevent osteoporosis and bone diseases Magnesium and Aluminum Containing Antacids – [medindia.net]
Your skin Holds body fluids in, preventing dehydration Keeps harmful microbes out, preventing infections Helps you feel things like heat, cold, and pain Keeps your body temperature even Makes vitamin D when the sun shines on it Anything that irritates [icdlist.com]
A complete excision prevents recurrence. Psychological support is required in association with surgery because the lesions are benign and concern an intimate part of the body. [ncbi.nlm.nih.gov]
Additional information Funding This work was supported in part by an Unrestricted Grant from Research to Prevent Blindness, Inc., New York, NY, to the Department of Ophthalmology & Visual Sciences, University of Utah. [tandfonline.com]