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Tumoral calcinosis: Evidence for concurrent defects in renal tubular phosphorus transport and in 1α,25-dihydroxycholecalciferol synthesis

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Summary

A 50-year-old Latin American man with tumoral calcinosis presented with hyperphosphatemia (6.62±1.04 SD mg/dl), elevated renal threshold phosphorus concentration (TmP) (7.3 mg/GFR), and 1,25-dihydroxyvitamin D [1,25-(OH)2D] (69 pg/ml) hypercalciuria (239 mg/day), and a high fractional intestinal calcium (Ca) absorption (0.74). Sodium cellulose phosphate therapy (20 g/day) lowered urinary Ca, and partially reduced serum phosphorus (P) and TmP to 5.91±0.63 mg/dl and 6.2 mg/GFR, respectively. Serum 1,25-(OH)120D remained elevated at 58–64 pg/ml. Amphojel therapy (4 oz/day) decreased urinary P to 23±21 mg/day and lowered serum P to 5.75±0.36 mg/dl (P<0.05). TmP increased to a value of 8.0 mg/GFR while serum 1,25-(OH)2D continued to remain elevated at 53 pg/ml.

This case illustrates the probable operation of dual abnormalities in tumoral calcinosis represented by augmented renal conservation of P and an elevation in the circulating concentration of 1,25-(OH)2D.

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  1. Section on Mineral Metabolism, Department of Internal Medicine, Southwestern Medical School, The University of Texas Health Science Center at Dallas, 5323 Harry Hines Blvd., 75235, Dallas, Texas, USA

    Joseph E. Zerwekh, Lou A. Sanders, Judith Townsend & Charles Y. C. Pak

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  1. Joseph E. Zerwekh
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  2. Lou A. Sanders
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  3. Judith Townsend
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  4. Charles Y. C. Pak
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Zerwekh, J.E., Sanders, L.A., Townsend, J. et al. Tumoral calcinosis: Evidence for concurrent defects in renal tubular phosphorus transport and in 1α,25-dihydroxycholecalciferol synthesis. Calcif Tissue Int 32, 1–6 (1980). https://doi.org/10.1007/BF02408515

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  • DOI: https://doi.org/10.1007/BF02408515

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