RESUMO
Rhabdomyolysis (RD) is the process that leads to cell destruction of striated muscle. Causes include inherited metabolic defects or acquired disorders. RD is frequently associated with acute kidney injury (AKI) and disorders of calcium metabolism. We report a 33 year old man that after amphetamine consumption and an uninterrupted 3,000 km driving presented vomiting, muscle pain and dark urine. He had elevated creatinkinase levels, severe hypocalcemia and an acute renal failure. He was treated with hemodialysis and calcitriol. He was transferred to our hospital and on admission a serum calcium of 18 mg/dl was detected. He continued on hemodialysis, recovering renal function and with normalization of creatinkinase levels and serum calcium level.
Assuntos
Humanos , Masculino , Adulto , Rabdomiólise/complicações , Injúria Renal Aguda/etiologia , Hipercalcemia/etiologia , Cintilografia/métodos , Cálcio/sangue , Diálise Renal/métodos , Creatina Quinase/sangue , Injúria Renal Aguda/terapia , Hipercalcemia/diagnóstico por imagem , Hipocalcemia/etiologiaRESUMO
Abstract A 37-year-old man with AIDS presented with altered mental status four weeks after stopping his medications for Mycobacterium avium-intracellulare (MAI). He had low CD4 cell count and severe hypercalcemia. Bone marrow biopsy revealed bone marrow infiltration by granulomas positive for acid-fast bacilli and cultures grew MAI. His hypercalcemia continued to worsen with the initiation of MAI therapy but we were able to treat it successfully with pamidronate and calcitonin.
Assuntos
Humanos , Masculino , Adulto , Infecção por Mycobacterium avium-intracellulare/complicações , Infecções Oportunistas Relacionadas com a AIDS/complicações , Hipercalcemia/microbiologia , Hipercalcemia/diagnóstico por imagem , Medula Óssea/microbiologia , Medula Óssea/patologia , Imageamento por Ressonância Magnética , Complexo Mycobacterium avium/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Contagem de Linfócito CD4 , Hipercalcemia/tratamento farmacológicoRESUMO
We report a 30-day-old baby with subcutaneous fat necrosis and symptomatic hypercalcemia, who developed metastatic calcification in the subcutaneous tissue, kidneys, pericardium and brain. The baby also had anemia, hypertriglyceridemia and hypercholesterolemia. He was managed with intravenous saline, furosemide, oral steroids and bisphosphonates and improved with treatment.
Assuntos
Encéfalo/diagnóstico por imagem , Calcinose/epidemiologia , Calcinose/patologia , Humanos , Hipercalcemia/epidemiologia , Hipercalcemia/diagnóstico por imagem , Recém-Nascido , Masculino , Necrose/epidemiologia , Necrose/patologia , Gordura Subcutânea/patologia , Tomografia Computadorizada por Raios XRESUMO
Hypercalcemia in accelerated phase of chronic myelogenous leukemia (CML) is very rare. Its pathogenesis is considered humoral hypercalcemia of malignancies mediated by parathyroid hormone-related protein (PTHrP). In severe hypercalcemia, calcifications in kidneys, skin, vessels, heart, and stomach may occur. Our two cases were admitted because of severe hypercalcemia in accelerated phase of CML. On Tc-99m methylene diphosphonate (MDP) bone scintigraphies, a marked tracer accumulation was seen in the lung, heart, stomach and kidney. We report increased tracer accumulation of multiple organs on Tc-99m MDP bone scintigraphy in two rare hypercalcemic patients with CML.