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首页> 外文期刊>Case Reports in Nephrology >Treatment of Severe Tumoral Calcinosis with Teriparatide in a Dialysis Patient after Total Parathyroidectomy
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Treatment of Severe Tumoral Calcinosis with Teriparatide in a Dialysis Patient after Total Parathyroidectomy

机译：在总甲状旁腺切除术后透析患者中萜壶肽治疗严重肿瘤辅酶

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Tumoral calcinosis is a rare but debilitating condition that can affect dialysis patients. Optimal management is largely unknown. We report the clinical course, treatment, and outcome of a peritoneal dialysis (PD) patient who developed tumoral calcinosis refractory to conventional treatment but improved with teriparatide therapy. A 26-year-old lady on PD for 2 years presented to us with tumoral calcinosis involving bilateral hands. Response to surgical excision, parathyroidectomy, and conversion to hemodialysis failed to result in sustained remission, and tumoral calcinosis progressed. After total parathyroidectomy, the patient had transient but partial remission in which her calcinosis deposits remained but were asymptomatic without pain or clinical signs of inflammation. However, she later experienced a relapse with involvement of the left elbow, right shoulder, right hip, and right thigh. Tumoral calcinosis remained uncontrolled resulting in debilitation, likely attributable to poor calcium and phosphate control because of adynamic bone disease after parathyroidectomy despite treatment of superimposed tuberculosis and therapy with sodium thiosulphate and pamidronic acid. Clinical improvement was however evident after the use of teriparatide. Asymptomatic hypocalcemia occurred after teriparatide therapy but resolved after 2 months. In conclusion, teriparatide appears to be useful for treating tumoral calcinosis in the presence of adynamic bone disease. Hypocalcemia can occur in the initial months of therapy.
机译：肿瘤钙化是一种罕见但衰弱的病症，可以影响透析患者。最佳管理在很大程度上是未知的。我们报告了腹膜透析（Pd）患者的临床过程，治疗和结果，该患者患者对常规治疗产生了肿瘤溶质耐火材料但随着Teriparatide治疗而改善。一位26岁的女士在PD上呈现给我们2年，患有涉及双方手的肿瘤辅病症。对手术切除，甲状旁腺切除术和转化对血液透析的反应未能导致缓解持续缓解，并且肿瘤辅病症进展。在总甲状旁腺切除术后，患者有短暂但部分缓解，其中她的钙质沉积物仍然存在，但没有疼痛或炎症的临床症状无症状。然而，她后来经历了左肘，右肩，右臀部和右大腿的参与复发。肿瘤钙化仍然是不受控制的，导致脱疏的钙和磷酸盐对照，因为脱甲状腺切除术后甲状腺肿瘤切除术后的表达骨病，尽管用硫代硫酸钠和磷磷酸钠治疗，但脱甲醛切除术后可能会归因于钙和磷酸盐对照。然而，在使用TeriparaTide之后，临床改善是显而易见的。无症状的低钙血症发生在萜段治疗后发生，但在2个月后解决。总之，Teriparatide似乎有助于治疗动力骨病存在下的肿瘤辅病症。治疗初始月份可能发生低钙血症。

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