腎不全に併発した転移性皮膚石灰沈着症

・腎不全に併発した転移性皮膚石灰沈着症（metastatic calcinosis cutis）の1例を経験した．

・自験例はビタミンD製剤，カルシウムサプリメントの長期摂取が腎不全の増悪ならびに石灰沈着症の誘因と考えられた．

・石灰沈着症の診断においては,基礎疾患の有無,血液検査ならびに薬剤，サプリメントなどの摂取歴を聴取する必要がある．

（「症例のポイント」より）

　

A case of metastatic calcinosis cutis associated with renal failure

　

Watabe, Daisuke1）Akasaka, Toshihide2）Kan, keiko3）Amano, Hiroo1） 1）Department of Dermatology, Iwate Medical University School of Medicine 2）Division of Dermatology, Kitakami Saiseikai Hospital 3）Kan Orthopedics and Dermatology Clinic

　

A 61-year-old woman presented with a cutaneous nodule on the left knee that had been present for 5 years. Physical examination revealed multiple, hard, yellow-whitish nodules in the periarticular regions. X-ray examination of the left hand demonstrated calcified nodules on the periarticular tissues. Histologically, nodular calcified masses were evident in the dermis and subcutaneous tissue. Laboratory examinations revealed elevated levels of serum calcium and phosphate at 12.1 mg/dl and 5.2 mg/dl, respectively. The level of intact PTH was normal. These findings were consistent with metastatic calcification associated with renal failure and hypercalcemia due to chronic ingestion of vitamin D and calcium supplement. After improvement of renal function, the skin nodules resolved gradually.