Progressive osteosclerosis and visceral calcification after cord blood transplantation.
A 26-year-old woman, who successfully underwent umbilical cord blood transplantation for aplastic anemia 4 years previously, had suffered from hepatosplenic microabscesses caused by unidentifiable grocott stain-positive spores from immediately after the transplantation. At 51 months post-transplant, we attempted bone marrow biopsy from her posterior iliac crest, but failed to penetrate the cortical bone. X-ray of her spine and pelvis showed marked and diffuse osteosclerosis. Retrospective analysis of computed tomography revealed the gradual replacement of sternal, vertebral, and pelvic bone marrow with calcified tissues in addition to the dispersed calcification of the liver, spleen, and kidneys over the last 2 years. The bone mineral density of the lumbar spine had increased but not that of the femoral neck. Biomedical parameters for bone remodeling demonstrated enhanced bone formation as well as bone resorption and secondary hyperparathyroidism. Based on the past reports, we suggest that chronic fungal infection, which caused visceral calcification, induced the production of humoral factors for osteoblastic activation.
Asada
Noboru
N
Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Ishii
Shinichi
S
Wakahashi
Kanako
K
Kawano
Hiroki
H
Kawamori
Yuriko
Y
Nishikawa
Shinichiro
S
Minagawa
Kentaro
K
Okamura
Atsuo
A
Shimoyama
Manabu
M
Katayama
Yoshio
Y
Hayashi
Yoshitake
Y
Itoh
Tomoo
T
Tanimoto
Mitsune
M
Matsui
Toshimitsu
T
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D018450:Disease Progression; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D010026:Osteosclerosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011859:Radiography