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A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy

A 43-year-old haemodialysis patient was admitted to hospital because of paroxysmal pain in the upper abdominal region radiating to the back. Laboratory tests showed severe hyperparathyroidism [intact parathyroid hormone (iPTH) 69 pmol/L; reference range: 1.3–6.8 pmol/L], hypercalcaemia (2.79 mmol/L)...

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Autores principales: Kampschreur, Linda M., Hoogeveen, Ellen K., op den Akker, Jeroen W., Beutler, Jaap J., Beems, Tjemme, Dorresteijn, Lucille D. A., de Sévaux, Ruud G. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477967/
https://www.ncbi.nlm.nih.gov/pubmed/28657067
http://dx.doi.org/10.1093/ndtplus/sfq052
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author Kampschreur, Linda M.
Hoogeveen, Ellen K.
op den Akker, Jeroen W.
Beutler, Jaap J.
Beems, Tjemme
Dorresteijn, Lucille D. A.
de Sévaux, Ruud G. L.
author_facet Kampschreur, Linda M.
Hoogeveen, Ellen K.
op den Akker, Jeroen W.
Beutler, Jaap J.
Beems, Tjemme
Dorresteijn, Lucille D. A.
de Sévaux, Ruud G. L.
author_sort Kampschreur, Linda M.
collection PubMed
description A 43-year-old haemodialysis patient was admitted to hospital because of paroxysmal pain in the upper abdominal region radiating to the back. Laboratory tests showed severe hyperparathyroidism [intact parathyroid hormone (iPTH) 69 pmol/L; reference range: 1.3–6.8 pmol/L], hypercalcaemia (2.79 mmol/L), hyperphosphataemia (1.6 mmol/L) and elevated serum total alkaline phosphatase (200 U/L). After developing a disturbed sensation and paraesthesia in both feet, epidural compression of the spinal cord was suspected. Magnetic resonance imaging showed a tumour that severely compressed the myelum of the thoracic spine. Histological investigation revealed a brown tumour or osteoclastoma, an erosive bony lesion caused by increased osteoclastic activity and peritrabecular fibrosis. A brown tumour is a benign tumour that is a rare complication of severe renal hyperparathyroidism. The brown tumour developed despite a 1-year treatment of the patient with cinacalcet, which, however, did not result in a major decrease in serum iPTH concentration (from 110 to 69 pmol/L: 37% reduction). Urgent decompressive neurosurgery and subtotal parathyroidectomy resulted in a complete recovery.
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spelling pubmed-54779672017-06-27 A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy Kampschreur, Linda M. Hoogeveen, Ellen K. op den Akker, Jeroen W. Beutler, Jaap J. Beems, Tjemme Dorresteijn, Lucille D. A. de Sévaux, Ruud G. L. NDT Plus Case Report A 43-year-old haemodialysis patient was admitted to hospital because of paroxysmal pain in the upper abdominal region radiating to the back. Laboratory tests showed severe hyperparathyroidism [intact parathyroid hormone (iPTH) 69 pmol/L; reference range: 1.3–6.8 pmol/L], hypercalcaemia (2.79 mmol/L), hyperphosphataemia (1.6 mmol/L) and elevated serum total alkaline phosphatase (200 U/L). After developing a disturbed sensation and paraesthesia in both feet, epidural compression of the spinal cord was suspected. Magnetic resonance imaging showed a tumour that severely compressed the myelum of the thoracic spine. Histological investigation revealed a brown tumour or osteoclastoma, an erosive bony lesion caused by increased osteoclastic activity and peritrabecular fibrosis. A brown tumour is a benign tumour that is a rare complication of severe renal hyperparathyroidism. The brown tumour developed despite a 1-year treatment of the patient with cinacalcet, which, however, did not result in a major decrease in serum iPTH concentration (from 110 to 69 pmol/L: 37% reduction). Urgent decompressive neurosurgery and subtotal parathyroidectomy resulted in a complete recovery. Oxford University Press 2010-06 2010-04-14 /pmc/articles/PMC5477967/ /pubmed/28657067 http://dx.doi.org/10.1093/ndtplus/sfq052 Text en © The Author 2010. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Kampschreur, Linda M.
Hoogeveen, Ellen K.
op den Akker, Jeroen W.
Beutler, Jaap J.
Beems, Tjemme
Dorresteijn, Lucille D. A.
de Sévaux, Ruud G. L.
A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
title A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
title_full A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
title_fullStr A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
title_full_unstemmed A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
title_short A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
title_sort haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477967/
https://www.ncbi.nlm.nih.gov/pubmed/28657067
http://dx.doi.org/10.1093/ndtplus/sfq052
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