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Uremic tumoral calcinosis in distal phalanges: a case report
Uremic tumoral calcinosis in distal phalanges: a case report
Luis E. Castillo-Pérez 1 
, Jesús A. García-Ruvalcaba 1 , Marcela García-Dena 1 , Ronald González-Jaimes 2
1 Servicio de Medicina Interna, Hospital General Regional No. 66, Instituto Mexicano del Seguro Social, Ciudad Juárez, Chihuahua, Mexico; 2 Servicio de Nefrológía. Hospital General Regional No. 66, Instituto Mexicano del Seguro Social, Ciudad Juárez, Chihuahua, Mexico
*Correspondence: Luis E. Castillo-Pérez. Email: Luis.e.castillo.9@outlook.com
Abstract
Uremic tumoral calcinosis (UTC) is an uncommon complication of advanced chronic kidney disease. We report a 47-year-old woman on hemodialysis who presented with bilateral periarticular swelling in the distal phalanges, confirmed by radiography as nodular calcifications. Laboratory findings showed intact parathyroid hormone 1086.5 pg/mL, phosphorus 6.8 mg/dL, and alkaline phosphatase (ALP) 347 U/L, with normal serum calcium. A 47-month retrospective analysis documented hyperphosphatemia in 75.4% of measurements and persistently elevated ALP, with consistently normal calcium. This case highlights that UTC may present in atypical locations through cumulative metabolic exposure, emphasizing the need for longitudinal mineral-bone monitoring in dialysis patients.
Keywords: Calcinosis. Hyperphosphatemia. Secondary hyperparathyroidism. Chronic kidney disease. Hemodialysis.
