Acute tumoral calcinosis due to severe hyperphosphatemia in a maintenance hemodialysis patient.

Abstract

We report the case of a maintenance hemodialysis patient with severe hyperphosphatemia (26.6mg/dL) who developed acute tumoral calcinosis. The patient started receiving maintenance hemodialysis after being diagnosed with type 2 diabetes mellitus. The patient's phosphate levels suddenly increased. He had not taken the prescribed phosphate binders for the past 5years. He noticed swelling of the palmar aspects of his right thumb, which was diagnosed as tumoral calcinosis. His serum phosphate level reached 26.6mg/dL. He started taking medication to lower his serum phosphate levels. The patient had a long history of eating convenience foods. As food additives in convenience foods could be a major source of phosphate, the patient corrected this habit by replacing convenience foods with special foods for dialysis patients. His symptoms improved along with the decrease in his serum phosphate levels. The main reason for the abrupt decrease in phosphate levels could be the correction of his dietary habits. Therefore, phosphate levels in processed foods should be carefully considered in dialysis patients.