Original article | Volume 32, Article 76, 12 Feb 2019 | 10.11604/pamj.2019.32.76.18187

Subcutaneous calcinosis: a rare complication of chronic hypercalcemia

Fatima Zahra Zaher, Nawal El Ansari

Corresponding author: Fatima Zahra Zaher, Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Marrakech, Marrakech, Morocco

Received: 17 Jan 2019 - Accepted: 27 Jan 2019 - Published: 12 Feb 2019

Domain: Endocrinology

Keywords: Subcutaneous calcinosis, hypercalcemia, primary hyperparathyroidism

©Fatima Zahra Zaher et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Fatima Zahra Zaher et al. Subcutaneous calcinosis: a rare complication of chronic hypercalcemia. Pan African Medical Journal. 2019;32:76. [doi: 10.11604/pamj.2019.32.76.18187]

Available online at: https://www.panafrican-med-journal.com/content/article/32/76/full

Home | Volume 32 | Article number 76

Original article

Subcutaneous calcinosis: a rare complication of chronic hypercalcemia

Subcutaneous calcinosis: a rare complication of chronic hypercalcemia

Fatima Zahra Zaher1,&, Nawal El Ansari1

 

1Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Marrakech, Marrakech, Morocco

 

 

&Corresponding author
Fatima Zahra Zaher, Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Marrakech, Marrakech, Morocco

 

 

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Subcutaneous calcinosis is a rare entity that may be secondary to either tissue damage, phosphocalcic disturbance or idiopathic origin. In the context of hypercalcemia, subcutaneous calcinosis remains a rare complication with few cases reported in the litterature. We report the case of a 27-year-old patient admitted for chronic hypercalcemia with right femur fracture and renal failure. Clinical examination found hard, painless, non-inflammatory subcutaneous nodules at the 2 elbows and at the lower gum (Panel A), the elbow radiography showed radiopaque structures in favor of subcutaneous calcinosis (Panel B). The etiological investigations of hypercalcemia showed a parathyroid hormon at 2200ng/ml (15-65), with cervical ultrasound showing a right inferior parathyroid nodule of 3cm * 1.6cm, in favor of primary hyperparathyroidism. The evolution was marked by the decrease of the size of the lesions in 15 days after normalization of the phosphocalcic balance after a symptomatic treatment based on intravenous rehydration, diuretics, corticosteroid bolus and bisphosphonate. Although hypercalcemia can reach very high serum levels in primary hyperparathyroidism, it is rarely accompanied by subcutaneous calcinosis. Indeed, it is hyperphosphoremia which represents the main factor involved in the development of cutaneous calcinosis in the context of phosphocalcic disturbances, and this independently of the level of hypercalcemia. Lesions tend to resolve spontaneously when calcium and phosphate levels normalize.

 

 

Figure 1: subcutaneous calcinosis: (A) calcifications of the lower gum; (B) radiological appearance of subcutaneous calcifications of the elbow

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Original article

Subcutaneous calcinosis: a rare complication of chronic hypercalcemia

Original article

Subcutaneous calcinosis: a rare complication of chronic hypercalcemia

Original article

Subcutaneous calcinosis: a rare complication of chronic hypercalcemia

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Key words

Subcutaneous calcinosis

Hypercalcemia

Primary hyperparathyroidism

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Subcutaneous calcinosis: a rare complication of chronic hypercalcemia