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A. Tumoral Calcinosis
Extraosseous calcification is more common in the secondary than in the primary form of disease. This includes tumoral calcification and renal calcification.
- Is most often associated with chronic renal failure.
- Osseous manifestations include: subperiosteal bone resorption, intracortical bone resorption, endosteal resorption, subchondral resorption.
- Characterized by pronounced parathyroid gland hyperplasia resulting from end-organ resistance to parathyroid hormone (PTH).
- Hypersecretion of PTH depresses calcium levels.
- In chronic renal failure hyperphosphatemia and damaged renal parenchyma leads to a reduction of 1-a-(OH)2 D3, or 1,25-dihydroxycholecalciferol (1,25-DHCC).
- Intestinal absorption of vitamin D is decreased.
- Calcium mobilization is impaired due to PTH resistance.
Resnick D, Niwayama G. Parathyroid disorders and renal osteodystrophy. In: Resnick D, eds. Diagnosis of bone and joint disorders. 3rd ed. Philadelphia, Pa: Saunders, 1995; 2014-2015.