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Figure 1. Metastatic Calcification of the Shoulder in Chronic Renal Failure.
A 32-year-old man with chronic renal failure (from IgA nephropathy) being treated with maintenance hemodialysis began to take his phosphate-binding medications irregularly, and swelling of the right shoulder developed over a period of two months. The calcium-phosphate product (in milligrams per deciliter) was more than 90, and the serum N-terminal parathyroid hormone level was elevated. A biopsy of the shoulder mass (arrow) revealed hydroxyapatite. The patient underwent subtotal parathyroidectomy and was referred for renal transplantation.
Hamid Rabb, M.D. German Ramirez, M.D. James A. Haley VeteransAffairs Hospital Tampa, FL . . . [Full Text of this Article]