A case of hyperoxaluria. Radiological aspects.
OBJECTIVE
Oxalosis is an unusual pathological condition with calcium oxalate deposits in soft tissue and bone, recognized as osteosclerosis on radiography. Osteosclerotic bone changes in patients treated with hemodialysis are in most cases due to secondary hyperparathyroidism, but several other diagnoses have to be considered.


RESULTS
We describe the case of a young woman with advanced renal failure treated with hemodialysis since her youth. She had skeletal pain and radiological examination showed: osteosclerosis with sclerotic vertebral bodies; irregular sclerosis and unsharp periostal outline in the tubular bones of the extremities; and acrolysis and calcifications of vascular and soft tissue in the hands. Histological examination showed changes typical of oxalosis. A liver biopsy excluded primary oxalosis type I, and she probably had a secondary oxalosis due to renal failure. This condition (as opposed to primary oxalosis) can be treated with renal transplantation.


CONCLUSIONS
Oxalosis is a rare condition but it should be considered in patients with radiological skeletal changes and chronic renal failure and should not be misinterpreted as renal osteodystrophy. The classification of oxalosis as primary or secondary is important for further treatment.
Elmståhl
B
B
Department of Diagnostic Radiology, Malmö University Hospital, Sweden.
Rausing
A
A
D000328:Adult; D001862:Bone Resorption / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000378:metabolism; D001133:Bones of Upper Extremity / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology; D002129:Calcium Oxalate / Q000378:metabolism; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006225:Hand / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D006959:Hyperoxaluria / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000628:therapy; D016030:Kidney Transplantation; D007867:Leg Bones / Q000000981:diagnostic imaging; D010026:Osteosclerosis / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology
D002129:Calcium Oxalate