title: Ectopic ossification in the cranial dura mater in dialysis patients with secondary hyperparathyroidism.
abstract: We report the case of a 69-year-old woman with secondary hyperparathyroidism who underwent maintenance haemodialysis therapy for 17 years and who presented with severe dural calcification and right subdural haematoma. Her dura mater displayed a rock barnacle-like appearance, and cerebral superficial arteries adhered to the sclerotic lesions. On the microscopic observation, calcified tissue with a clear lamellar structure and osteopontin immunoreactivity was observed. Tartrate-resistant acid phosphatase immunoreactive polynucleated giant cells infiltrated around the tissue. Such morphological properties are specific to the calcified tissue formed through a bone formation-like mechanism that is often observed in arterial media in patients with chronic kidney disease.
authors.affiliation: Division of Nephrology , Joetsu General Hospital , Joetsu.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Oyama
authors.affiliation: Division of Clinical Nephrology and Rheumatology , Niigata University Graduate School of Medical and Dental Sciences , Niigata.
authors.forename: Junichiro J
authors.initials: JJ
authors.lastname: Kazama
authors.affiliation: Division of Nephrology , Joetsu General Hospital , Joetsu.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Fukagawa
authors.affiliation: Division of Brain Surgery , Joetsu General Hospital , Joetsu , Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arakawa
authors.affiliation: Division of Brain Surgery , Joetsu General Hospital , Joetsu , Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Ezuka
keywords: dura matter; ectopic ossification; secondary hyperparathyroidism; subdural haematoma; tartrate-resistant acid phosphatase