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Medial arterial calcification mimicking temporal arteritis.
Ahmed I Al-Absi1, Barry M Wall, C Robert Cooke
1Department of Nephrology, University of Tennessee Health Science Center, Veterans Affairs Medical Center, Memphis, TN 38104, USA.
Summary
Medial arterial calcification in end-stage renal disease (ESRD) patients can mimic other vascular diseases, presenting with symptoms like headaches and vision changes. This case highlights the diverse clinical manifestations of arterial calcification in ESRD.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Vascular Biology
Background:
- Medial arterial calcification (MAC) is a growing concern in end-stage renal disease (ESRD) patients.
- MAC is linked to severe vascular complications like calcific uremic arteriolopathy and limb ischemia.
Observation:
- A 50-year-old ESRD patient on hemodialysis presented with symptoms mimicking temporal arteritis, including headaches and visual disturbances.
- Physical examination revealed tender, nodular superficial temporal arteries.
- Temporal artery biopsy confirmed MAC with minimal inflammation, excluding giant cells.
Findings:
- The patient developed additional complications: penile ischemic ulceration and mitral annulus calcification.
- Clinical presentation included headaches, blurred vision, arthralgias, and jaw claudication.
- Medial arterial calcification in ESRD can present with symptoms similar to other vascular conditions.
Implications:
- This case underscores the importance of considering MAC in ESRD patients with seemingly unrelated vascular symptoms.
- Recognizing MAC's varied presentations is crucial for accurate diagnosis and management in ESRD.
- Further research into the pathogenesis and treatment of MAC in ESRD is warranted.