title: Simultaneous multiple tendon ruptures complicating a seizure in a haemodialysis patient.
abstract: Non-traumatic rupture of large tendons is identified as a contributor to morbidity in patients who receive haemodialysis. The injury is likely to become more common as the duration of survival on dialysis extends. A number of predisposing factors leading to tendon injury have been identified in the literature, including secondary hyperparathyroidism, beta(2)-microglobulin associated amyloidosis, corticosteroid treatment and fluoroquinolone antibiotic use. This is a case report of a 31-year-old male who presented with simultaneous large tendon ruptures following epileptiform seizures. These occurred after 10 years of treatment for end-stage renal failure, including haemodialysis, with progressive secondary hyperparathyroidism. A review of the literature confirms progressive hyperparathyroidism as an important risk factor for large tendon rupture in patients on haemodialysis.
authors.affiliation: Department of Nephrology, Dunedin Hospital, Dunedin, New Zealand. suetoniapalmer@clear.net.nz
authors.forename: Suetonia
authors.initials: S
authors.lastname: Palmer
authors.forename: Christopher
authors.initials: C
authors.lastname: Birks
authors.forename: John
authors.initials: J
authors.lastname: Dunbar
authors.forename: Robert
authors.initials: R
authors.lastname: Walker
mesh_terms: D000328:Adult; D004551:Elbow Joint; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007719:Knee Joint; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects; D012422:Rupture, Spontaneous / Q000209:etiology; D012640:Seizures / Q000150:complications*; D013710:Tendons