Kidney Week

Abstract: PUB033

Sagliker Syndrome and Uremic Tumoral Calcinosis: Rare Complications of CKD-MBD

Session Information

• Publication Only

Category: Bone and Mineral Metabolism

• 502 Bone and Mineral Metabolism: Clinical

Authors

• Rafaey, Wania, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Wania Rafaey, MD, MBBS

• Jan, Muneeb Ullah, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Muneeb Ullah Jan, MD

• Khaliq, Muhammad, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Muhammad Khaliq, MD, MBBS

• Vo, Hieu Q., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Hieu Q. Vo, MD

• Hastings, Margaret Colleen, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Margaret Colleen Hastings, MD, FASN

Introduction

Chronic kidney disease- Mineral bone disorders result from imbalance of calcium, phosphorus and PTH. Herein, we discussed rare and severe sequels of CKD-MBD.

Case Description

Case 1
A young female with ESRD, developed bilateral hips pain and swellings in fingers. Blood workup showed secondary hyperparathyroidism with hyperphosphatemia. Imaging showed extensive calcification in muscles adjacent to hips on CT CAP (Figure:1) and metastatic calcification on Xray hand. Parthyroid Scintigraphy showed parathyroid hyperplasia. Skin biopsy showed calciphylaxis.Initially treated with medical therapy but minimal response, underwent bilateral parathyroidectomy, on followup.
Case 2
A young male with ESRD,non-compliant, developed facial deformities and maxillofacial bone pain. Blood workup showed PTH of 4000 pg/mL and ALP >1000units/L. Imaging showed extensive dysplastic changes involving maxilla and mandible bone expansion and widening of diploic space (Figure:2). Parthyroid Scintigraphy showed parathyroid hyperplasia. Initially managed with conservative therapy, poor response, eventually underwent total parathyroidectomy.

Discussion

Sagliker syndrome and uremic tumoral calcinosis are rare and severe complications of CKD-MBD.These cases emphasize the importance of comprehensive management of CKD-MBD in preventing SHPT and subsequent bone and soft tissue complications. If left untreated, these conditions can profoundly impact patients both physically and psychologically,significantly reducing their quality of life.

Figure 1

Figure 2