Development of caseous calcification of mitral annulus after initiation of hemodialysis therapy
Development of caseous calcification of mitral annulus after initiation of hemodialysis therapy
复制标题
开始血液透析治疗后二尖瓣环发生干酪样钙化
DOI：
10.1016/j.jccase.2019.02.002
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Tsujita K
中科院分区：
文献类型：
--
作者：
Usuku H;Yamamoto E;Oike F;Tsunoda R;Nishigami K;Sakaguchi T;Suzuki R;Uekihara S;Matsui H;Tsujita K
我们在此报告一位59岁男性，在日本红十字会熊本医院接受腹膜透析（PD）7年及血液透析6年。开始PD后6年，经胸超声心动图显示二尖瓣后叶有一个横向直径约15 mm的高回声肿块。由于质量从开始血液透析后2年开始增加，在开始血液透析后6年达到25 mm以上，因此进行了肿瘤切除和二尖瓣置换术。切开肿块表面，可见白色乳白色液体流出，组织学检查可见多发钙化结节和肉芽组织，诊断为二尖瓣环干酪样钙化。学习目的：二尖瓣环干酪样钙化（CCMA）通常与终末期肾病相关。在本病例中，一名59岁的男性接受了7年的腹膜透析，之后又接受了6年的血液透析。在开始血液透析治疗后观察到CCMA的发展。常规超声心动图对CCMA的早期诊断有帮助，尤其是对透析方式由PD转为血液透析的患者。
We here present a 59-year-old man who had undergone peritoneal dialysis (PD) for 7 years and hemodialysis for the following 6 years in the Japanese Red Cross Kumamoto Hospital. Six years after commencing PD, transthoracic echocardiography showed a highly echoic mass with a transverse diameter of almost 15 mm in the posterior mitral leaflet. Because the mass increased from 2 years after initiation of hemodialysis, reaching over 25 mm by 6 years after commencing hemodialysis, tumor resection and mitral valve replacement were performed. When the surface of the mass was incised, white opalescent liquid drained out of the mass and histological examination showed multiple calcified nodules and granulation tissue, resulting in diagnosis of a caseous calcification of mitral annulus.<Learning Objective:Caseous calcification of mitral annulus (CCMA) is usually associated with end-stage renal disease. In the present case, a 59-year-old man had undergone peritoneal dialysis for 7 years, after which he had undergone hemodialysis for 6 years. The development of CCMA was seen after initiation of hemodialysis therapy. Routine echocardiography is useful for early diagnosis of CCMA, especially in patients whose type of dialysis changed from PD to hemodialysis.>