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Spontaneous and serial rupture of both Achilles tendons associated with secondary hyperparathyroidism in a patient receiving long-term hemodialysis
- Source :
- International urology and nephrology. 45(2)
- Publication Year :
- 2011
-
Abstract
- The spontaneous and serial rupture of the bilateral Achilles tendons without history of significant trauma is an uncommon complication in long-term hemodialysis (HD) patients. The majority of these patients have additional predisposing factors, such as previous use of fluoroquinolone antibiotics or corticosteroids. In general, this condition is associated with a coexisting systemic disease, including chronic kidney disease (CKD), secondary hyperparathyroidism, systemic lupus erythematosus (SLE), and diabetes mellitus (DM). Here, we report a 46-year-old man who had been undergoing regular HD for 11 years. He developed a spontaneous and consecutive rupture of both Achilles tendons. Based on previous reports of tendon ruptures in uremic patients and on the patient’s lack of corticosteroid or fluoroquinolone use, we believe that secondary hyperparathyroidism was the predisposing factor in this patient. The mechanism seems to be related to a high parathyroid hormone (PTH) level, which results in osteolytic bone resorption at the tendon insertion site. Treatment and prevention of such tendon ruptures include early surgical repair and control of secondary hyperparathyroidism, by use of vitamin D analogs, and total parathyroidectomy, with or without autotransplantation of a parathyroid gland.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Urology
medicine.medical_treatment
Parathyroid hormone
Achilles Tendon
Muscular Diseases
Renal Dialysis
medicine
Humans
Achilles tendon
Hyperparathyroidism
Rupture, Spontaneous
business.industry
Middle Aged
medicine.disease
Tendon
Surgery
medicine.anatomical_structure
Nephrology
Parathyroid gland
Secondary hyperparathyroidism
Hyperparathyroidism, Secondary
Hemodialysis
business
Kidney disease
Subjects
Details
- ISSN :
- 15732584
- Volume :
- 45
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- International urology and nephrology
- Accession number :
- edsair.doi.dedup.....c91ce5991780167f1f66401a9530c845