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2.1
Familial Normophosphatemic Tumoral Calcinosis
Tumoral Calcinosis with Normophosphatemia

Presentation

We present two cases of HFTC successfully managed with combination acetazolamide (ACTZ) and sevelamer carbonate. [bone-abstracts.org]

Case presentation Familial tumoral calcinosis was present in two members of a Han Chinese family, namely, the son and daughter. [jmedicalcasereports.biomedcentral.com]

In the present study, we describe a patient of Northern European origin displaying typical features of HFTC. [nature.com]

Classification of these conditions often presents many nosological challenges, since underlying etiologies and pathogenetics are often not known. [howlingpixel.com]

There are many conditions which present with a similar clinicoradiological picture like 2. [myslide.es]

Gastrointestinal

  • Polydipsia

    […] solutions at site of 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 [ncbi.nlm.nih.gov]

Skin

  • Hypopigmented Skin

    /subcutaneous calcinosis Normal blood phosphorus Congenital or early-onset punctate keratoderma of palms & soles Diffuse, irregularly shaped hypopigmented skin macules typically over arms & legs May have calcific tendinopathy Arterial calcification due [ncbi.nlm.nih.gov]

  • Hyperpigmentation

    […] from HFTC Biochemical Clinical Porphyria cutanea tarda UROD AD Dystrophic calcification in areas of pseudoscleroderma Ulcerated areas at pseudoscleroderma sites in some Normal blood phosphorus Blistering & skin fragility w/sun exposure Hypertrichosis/ hyperpigmentation [ncbi.nlm.nih.gov]

  • Hypertrichosis

    Distinguishing from HFTC Biochemical Clinical Porphyria cutanea tarda UROD AD Dystrophic calcification in areas of pseudoscleroderma Ulcerated areas at pseudoscleroderma sites in some Normal blood phosphorus Blistering & skin fragility w/sun exposure Hypertrichosis [ncbi.nlm.nih.gov]

Musculoskeletal

  • Proximal Muscle Weakness

    Elevated inflammatory markers (ESR/CRP) Normal blood phosphorus Other features of dermatomyositis (proximal muscle weakness, interstitial pulmonary disease, dysphagia, polyarthritis, Gottron's papules, heliotrope eruption) Other features of systemic sclerosis [ncbi.nlm.nih.gov]

  • Brachydactyly

    Subcutaneous ossifications Elevated blood parathyroid hormone due to end-organ resistance Low blood calcium, obesity Resistance to other hormones incl TSH, LH/FSH, GHRH Clinical features of Albright hereditary osteodystrophy incl short stature, round facies, brachydactyly [ncbi.nlm.nih.gov]

Eyes

  • Blurred Vision

    One had symptomatic sudden onset of blurred vision attributed to choroidal neovascularization secondary to angioid streaks 14 years after the initial diagnosis of HFTC [ McGrath et al 2010 ]. [ncbi.nlm.nih.gov]

Workup

This finding emphasizes the need for thorough hematologic workup, including marrow studies, in potential sibling donors especially when they lack a genetic marker for familial disease. [haematologica.org]

X-Ray

  • Muscle Calcification

    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

Of note, there are no long-term treatment data. [ncbi.nlm.nih.gov]

Only surgical treatment was performed in both patients with satisfactory prognosis. Conclusion This is the first report of Chinese familial tumoral calcinosis. The etiopathogenisis and treatment are discussed. [jmedicalcasereports.biomedcentral.com]

In secondary cases, medical treatment in the mainstay. Treatment failure warrants parathyroidectomy, and surgical excision should be the last resort in these cases. [wjgnet.com]

To determine whether dermatologic consultation decreases duration of hospital stay or intravenous antibiotic treatment duration in pat... Use of Dapsone in the Treatment of Chronic Idiopathic and Autoimmune Urticaria. [allmedx.com]

Prognosis

Although the pathogenesis of the calcification process in TC is still controversial, surgical removal is the mainstay treatment with a satisfactory prognosis. [jmedicalcasereports.biomedcentral.com]

A classification for tumoral calcinosis is devised that outlines potential pathogenetic mechanisms and predicts response to therapy and prognosis. [scienceopen.com]

The prognosis of the disease is good although patients often undergo many surgical procedures to remove the calcified tumours [20]. Normophosphataemic FTC is less prevalent than the hyperphosphataemic variant [19,26]. [plasticsurgerykey.com]

Etiology

Classification of these conditions often presents many nosological challenges, since underlying etiologies and pathogenetics are often not known. [howlingpixel.com]

Moreover, there is evidence that FTC is genetically heterogeneous and another gene might be implicated in the etiology of FTC. [grantome.com]

ETIOLOGY, PATHOGENESIS AND CLASSIFICATION Etiology of TC remains uncertain despite the several theories that have been proposed. [wjgnet.com]

They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]

Despite various investigations, the etiology of soft-tissue calcification is still not well-understood. [ijpd.in]

Epidemiology

Updated Molecular and Epidemiologic diagrams added to all new chapters. [books.google.com]

From Jump to: navigation, search Contents 1 Epidemiology 2 Pathology 3 Genetics 4 More General Terms 5 Internet Database 6 References Epidemiology uncommon Pathology life-threatening disorder massive periarticular, & seldom visceral, deposition of calcified [anvita.info]

Further study will focus on epidemiology in Asia, the mutations in genomics and the variance between Asian and Caucasian patients. [jmedicalcasereports.biomedcentral.com]

The presentations and ensuing discussions provided state-of-the-art, up-to-date information on epidemiology, diagnostics, pathomechanisms, and treatment potential relating to PXE, with translational implications. [pxe.org]

Association Between Psoriasis and Sexual and Erectile Dysfunction in Epidemiologic Stud... Preview https://www.ncbi.nlm.nih.gov/pubmed/30304327 JAMA Dermatology; Molina-Leyva A, Salvador-Rodriguez L et. al. [allmedx.com]

Pathophysiology

The phenotypic characterization of ppGalNAc-T3 deficient mice combined with pathophysiological in vitro and in vivo studies will provided new insight in the molecular biology of mucin-type O-glycosylation and its intriguing role in ectopic calcium crystal [grantome.com]

Further research, including identification of specific molecules transported by ABCC6, is necessary for development of global, pathophysiology-related approaches to treat this currently intractable disorder. [pxe.org]

The destabilizing nature of these mutations provides new insight into the pathophysiology of TC and exemplifies the physiological importance of FGF23 in phosphate and vitamin D metabolism. [scienceopen.com]

Tumoral calcinosis revisited: pathophysiology and treatment. Rheumatol Int 2005;25:55e9. [17] Seyahi A, Atalar AC, Ergin HK. Tumoral calcinosis: clinical and biochemical aspects of a patient treated with vinpocetine. [myslide.es]

Pathophysiology Deficiency of or resistance to FGF23 leads to hyperphosphatemia resulting in increased renal phosphate reabsorption and elevated or inappropriately normal 1,25D production, which promotes gastrointestinal absorption of phosphorus and calcium [ncbi.nlm.nih.gov]

Prevention

Get optimal test results with guidance on error detection, correction, and prevention as well as cost-effective test selection. [books.google.com]

We hypothesize that ppGalNAc-T3 deficiency is associated with a decrease in extracellular inorganic pyrophosphate (ePPi), which at normal levels prevents basic calcium phosphate crystal depositions in joints and other tissues. [grantome.com]

Once the diagnosis is established, complete surgical excision is the only option for cure and prevention of recurrence. References 1. Pakasa NM, Kalengayi RM. [archintsurg.org]

Conclusion Primary idiopathic Tumoural Calcinosis is still a disease of unknown cause but complete surgical resection is an effective method of management of this disese and it prevents recurrence. [oapublishinglondon.com]

Although delayed treatment of JDM has been mentioned as one of the risk factors which cause calcinosis, early treatment with systemic steroid has not been shown to ensure prevention of calcinosis in a previous prospective study 10. [synapse.koreamed.org]

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