Recurrent Inflammatory State due to Severe Periarticular Calcifications in a Patient on Hemodialysis: A Case Report

Area of Science:

• Nephrology
• Rheumatology
• Pathology

Background:

• Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in hemodialysis patients.
• Periarticular calcifications are a recognized, though less common, manifestation of CKD-MBD.
• These calcifications can lead to significant morbidity, including inflammatory responses.

Purpose of the Study:

• To report a case of severe periarticular calcifications in a hemodialysis patient.
• To highlight the diagnostic challenges in differentiating calcification-induced inflammation from infection or autoimmune disease.
• To evaluate the efficacy of low-dose prednisolone in managing this specific complication.

Main Methods:

• Case report of a hemodialysis patient presenting with recurrent inflammatory symptoms.
• Diagnostic workup including exclusion of infectious and autoimmune etiologies.
• Treatment with low-dose prednisolone and monitoring of clinical outcomes.

Main Results:

• Diagnosis of CKD-MBD-related periarticular calcifications confirmed after excluding other causes.
• Significant reduction in inflammatory episodes and associated hospitalizations following prednisolone treatment.
• Symptomatic improvement and enhanced patient quality of life.

Conclusions:

• Periarticular calcifications secondary to CKD-MBD can present as a severe inflammatory condition mimicking infection.
• Systematic exclusion of other causes is crucial for accurate diagnosis.
• Low-dose corticosteroids represent a viable therapeutic option for managing inflammation in this context.