To the Editor: The medical mystery in the July 25 issue1 involveda 34-year-old woman who was receiving dialysis and who had hadmultiple admissions for uremic pericarditis. An abdominal radiograph(Figure 1) was obtained during an evaluation for abdominal pain.The uremic pericarditis was the probable cause of referred abdominalpain. The patient had received two renal transplants, 18 and20 years earlier, and had undergone partial parathyroidectomy4 years earlier for hyperparathyroidism. The abdominal imageshows two ossified renal transplants and adjacent surgical clips.There are marked changes indicative of osteomalacia. No causeof the abdominal pain is evident on the abdominal image.
Figure 1. Abdominal Radiograph Showing Two Ossified Renal Transplants and Adjacent Surgical Clips.
Leslie A. Kory, M.D. Jacobi Medical Center Bronx, NY 10461
Editor's note: We received 116 responses to this medical mystery.Sixty-two of the respondents (53 percent) indicated that theimage showed calcified renal transplants. The remaining respondentssuggested a wide range of calcified structures and calcificationmechanisms.
References
Kory LA. A medical mystery. N Engl J Med 2002;347:260-260. [Free Full Text]
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