tailieunhanh - Báo cáo y học: "Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet: a case report."

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet: a case report. | Lenz et al. Journal of Medical Case Reports 2010 4 191 http content 4 1 191 jA CASE REPORTS CASE REPORT Open Access Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet a case report Oliver Lenz 1 Rhea Sancassani2 Carla Bottino3 and Alessia Fornoni 1 4 Abstract Introduction The medical management of secondary hyperparathyroidism in patients with end-stage renal disease involves a combination of dietary restrictions phosphate binders active vitamin D analogs and calcimimetics. Case presentation We report the case of a 36-year-old Hispanic dialysis patient originally from Cuba and now residing in the USA who developed severe bone pain and muscle twitching after starting low dose cinacalcet despite normal pre-dialysis ionized calcium and elevated parathyroid hormone. The clinical symptoms correlated with increased symmetrical uptake on bone scan that resolved rapidly upon discontinuation of cinacalcet. Conclusion Cinacalcet may induce severe bone pain and a unique bone scan uptake pattern in hemodialysis patients. Introduction The medical management of secondary hyperparathyroidism SHPT in patients with end-stage renal disease ESRD involves a combination of dietary restrictions phosphate binders active vitamin D analogs and calcimi-metics. Treatment is aimed at achieving the goals delineated in the Kidney Disease Outcomes Quality Initiative in order to avoid the adverse mineral metabolic abnormalities including renal bone disease and cardiovascular mortality. Cinacalcet Sensipar Amgen USA a type II calcimi-metic allosterically increases the sensitivity of the calcium-sensing receptor lowering the threshold for activation and thereby decreasing secretion of parathyroid hormone PTH 1 . Studies have demonstrated its ability to lower PTH without significantly increasing serum calcium phosphorus or the Ca X P product 2 . Although symptomatic hypocalcemia may be a concern in .