title: Spontaneous and simultaneous rupture of both Achilles tendons and pathological fracture of the femur neck in a patient receiving long-term hemodialysis.
abstract: Spontaneous rupture of the Achilles tendons in hemodialysis patients is a rare complication. The majority of these patients have additional predisposing factors, such as previous use of fluoroquinolone antibiotics or corticosteroids. Spontaneous rupture of bilateral Achilles tendons without any of those predisposing factors is exceptional. In this paper, we report a 43-year-old woman who had been undergoing regular hemodialysis for 16 years. She developed bilateral spontaneous and simultaneous rupture of the Achilles tendons. She also developed pathological fracture of right femur neck 3 years later. Based on previous cases of tendon ruptures in uremic patients and the lack of history for the use of corticosteroids or fluoroquinolones, we believe that secondary hyperparathyroidism is the predisposing factor in this patient.
authors.affiliation: Department of Rheumatology, Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey. kemalureten@yahoo.com
authors.forename: Kemal
authors.initials: K
authors.lastname: Ureten
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Oztürk
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozbek
authors.forename: Selman
authors.initials: S
authors.lastname: Unverdi
mesh_terms: D000125:Achilles Tendon / Q000473:pathology*; D000328:Adult; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology