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- Title
Atypical features of idiopathic tumoral calcinosis: An experience from JIPMER.
- Authors
Kumar, Ritesh; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Muthupillai, Vivekanandhan
- Abstract
Objective of Study: To evaluate the clinical features, radio- imaging, bone scan and biochemical parameters and efficacy of bisphosphonate in patients with idiopathic tumoral calcinosis. Materials and Methods: We retrospectively studied the 7 cases (3 males and 4 females) of idiopathic tumoral calcinosis over past 5 years. Clinical features, radio imaging, bone scan and biochemical parameters like serum calcium, phosphorus, TMP/GFR, intact PTH, 1, 25(OH) vit D and C-terminal FGF-23 were assessed. Three patients received the bisphosphonate and followed up over 1 to 4 years. Results: Median age of patients was 21 (5 to 47) years and common site of lesion were near the hip, elbow and shoulder joints. Five patients had hyperphosphatemic (mean serum phosphorus, 6 ± 0.75 mg/ dl) and two, normophosphatemic (mean serum phosphorus 3.5 mg/ dl) tumoral calcinosis. In hyperphosphatemic, three patients had low serum intact PTH (mean 6.9 ± 1.9 pg/ml) with high levels of C-terminal FGF-23[median 2620(582 to 5361 RU/ml)] and normal 1, 25(OH) vit D (mean, 28.9 ± 5.3 pg/ml) and calcium (mean 9.3 ± 0.2 mg/dl). One patient had increased tracer uptake in the right thyroid cartilage on Tc-99m MDP bone scan. Two patients with recurrent tumour following surgery and one patient with multifocal lesion received bisphosphonate. On follow-up there was decrease in size of lesion in one patient while in other two patients lesions were increased. Conclusions: Unusually low intact PTH in three patients, increased tracer uptake in right thyroid cartilage on bone scan in one patient and near complete response to bisphosphonate in one patient are the atypical features in our series of patients with idiopathic tumoral calcinosis.
- Subjects
CALCINOSIS; DIPHOSPHONATES; HYPERPHOSPHATEMIA
- Publication
Indian Journal of Endocrinology & Metabolism, 2017, Vol 21, p28
- ISSN
2230-8210
- Publication type
Article