title: Tumoral calcinosis after an injection of recombinant human erythropoietin in a dialysis patient.
abstract: Tumoral calcinosis is a rare form of soft tissue calcifications, initially described as an idiopathic condition, which could occur in uremic patients. Despite its distinct clinical and morphologic presentations, the underlying pathogenesis is unknown. We present a dialysis patient who developed tumoral calcinosis over the right shoulder after receiving a misplaced injection of human recombinant erythropoietin probably into the periarticular tissue. This case serves as an example highlighting the importance of periarticular inflammatory reaction in precipitating the development of the lesion in predisposed patients.
authors.affiliation: Renal Unit, Department of Medicine, Kwong Wah Hospital, Hong Kong SAR, China. apnwong@yahoo.com
authors.forename: Ping-Nam
authors.initials: PN
authors.lastname: Wong
authors.forename: Siu-Ka
authors.initials: SK
authors.lastname: Mak
authors.forename: Kin-Yee
authors.initials: KY
authors.lastname: Lo
authors.forename: Gensy M W
authors.initials: GM
authors.lastname: Tong
authors.forename: Elaine
authors.initials: E
authors.lastname: Gwi
authors.forename: Andrew K M
authors.initials: AK
authors.lastname: Wong
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002061:Bursa, Synovial / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002118:Calcium / Q000097:blood / Q000378:metabolism; D002119:Calcium Carbonate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015314:Dialysis Solutions / Q000737:chemistry; D004921:Erythropoietin / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000628:therapy; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced; D006965:Hyperplasia; D007273:Injections, Intramuscular / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000097:blood / Q000178:diet therapy / Q000209:etiology / Q000628:therapy; D007964:Leukocytosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood; D010349:Patient Compliance; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods; D011859:Radiography; D011994:Recombinant Proteins; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
chemical_list: D015314:Dialysis Solutions; D010281:Parathyroid Hormone; D011994:Recombinant Proteins; D004921:Erythropoietin; D002119:Calcium Carbonate; D002118:Calcium