Simultaneous multiple tendon ruptures complicating a seizure in a haemodialysis patient

Non-traumatic rupture of large tendons is identified as a contributor to morbidity in patients who receive haemodialysis. The injury is likely to become more common as the duration of survival on dialysis extends. A number of predisposing factors leading to tendon injury have been identified in the literature, including secondary hyperparathyroidism, beta(2)-microglobulin associated amyloidosis, corticosteroid treatment and fluoroquinolone antibiotic use. This is a case report of a 31-year-old male who presented with simultaneous large tendon ruptures following epileptiform seizures. These occurred after 10 years of treatment for end-stage renal failure, including haemodialysis, with progressive secondary hyperparathyroidism. A review of the literature confirms progressive hyperparathyroidism as an important risk factor for large tendon rupture in patients on haemodialysis.