Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy

Detalhes bibliográficos
Autor(a) principal: Zakout, R
Data de Publicação: 2012
Outros Autores: Perloiro, MC, Freitas, PT
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.10/804
Resumo: We present a patient with leptospirosis infection who presented septic shock with multiple-organ dysfunction syndrome, severe rhabdomyolysis and acute myocarditis. He developed biphasic blood calcium pattern with hypocalcemia in the oliguric phase followed by hypercalcemia during the recovery diuretic phase in the context of rhabdomyolysis and oliguric acute kidney injury. Meanwhile, he developed an extensive calcification of the myocardium. Severe renal magnesium wasting was observed during the convalescence phase. Follow-up showed progressive resorption and later almost total disappearance of the calcific deposits in the heart by the 18th month after discharge. Renal magnesium wasting decreased gradually, but yet persisted beyond the 18th and was normalized only by the 36th month after discharge. We discuss the pathophysiologic mechanisms involved in the myocardial calcification and renal magnesium wasting and suggest a possibility of a contributing role of magnesium renal wasting in mobilization of calcium deposits out of myocardium
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spelling Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathyLeptospirosisMyocardial calcificationAcute kidney injuryRhabdomyolysisMagnesium wasting nephropathyWe present a patient with leptospirosis infection who presented septic shock with multiple-organ dysfunction syndrome, severe rhabdomyolysis and acute myocarditis. He developed biphasic blood calcium pattern with hypocalcemia in the oliguric phase followed by hypercalcemia during the recovery diuretic phase in the context of rhabdomyolysis and oliguric acute kidney injury. Meanwhile, he developed an extensive calcification of the myocardium. Severe renal magnesium wasting was observed during the convalescence phase. Follow-up showed progressive resorption and later almost total disappearance of the calcific deposits in the heart by the 18th month after discharge. Renal magnesium wasting decreased gradually, but yet persisted beyond the 18th and was normalized only by the 36th month after discharge. We discuss the pathophysiologic mechanisms involved in the myocardial calcification and renal magnesium wasting and suggest a possibility of a contributing role of magnesium renal wasting in mobilization of calcium deposits out of myocardiumElmer PressRepositório do Hospital Prof. Doutor Fernando FonsecaZakout, RPerloiro, MCFreitas, PT2012-12-13T17:01:45Z2013-01-01T00:00:00Z2013-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.10/804engJ Med Cases. 2013;4(2):92-981923-4163info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T15:51:39Zoai:repositorio.hff.min-saude.pt:10400.10/804Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:52:00.839146Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
title Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
spellingShingle Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
Zakout, R
Leptospirosis
Myocardial calcification
Acute kidney injury
Rhabdomyolysis
Magnesium wasting nephropathy
title_short Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
title_full Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
title_fullStr Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
title_full_unstemmed Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
title_sort Reversible myocardial calcification following severe leptospirosis complicated with rhabdomyolysis-induced acute kidney injury and magnesium-wasting nephropathy
author Zakout, R
author_facet Zakout, R
Perloiro, MC
Freitas, PT
author_role author
author2 Perloiro, MC
Freitas, PT
author2_role author
author
dc.contributor.none.fl_str_mv Repositório do Hospital Prof. Doutor Fernando Fonseca
dc.contributor.author.fl_str_mv Zakout, R
Perloiro, MC
Freitas, PT
dc.subject.por.fl_str_mv Leptospirosis
Myocardial calcification
Acute kidney injury
Rhabdomyolysis
Magnesium wasting nephropathy
topic Leptospirosis
Myocardial calcification
Acute kidney injury
Rhabdomyolysis
Magnesium wasting nephropathy
description We present a patient with leptospirosis infection who presented septic shock with multiple-organ dysfunction syndrome, severe rhabdomyolysis and acute myocarditis. He developed biphasic blood calcium pattern with hypocalcemia in the oliguric phase followed by hypercalcemia during the recovery diuretic phase in the context of rhabdomyolysis and oliguric acute kidney injury. Meanwhile, he developed an extensive calcification of the myocardium. Severe renal magnesium wasting was observed during the convalescence phase. Follow-up showed progressive resorption and later almost total disappearance of the calcific deposits in the heart by the 18th month after discharge. Renal magnesium wasting decreased gradually, but yet persisted beyond the 18th and was normalized only by the 36th month after discharge. We discuss the pathophysiologic mechanisms involved in the myocardial calcification and renal magnesium wasting and suggest a possibility of a contributing role of magnesium renal wasting in mobilization of calcium deposits out of myocardium
publishDate 2012
dc.date.none.fl_str_mv 2012-12-13T17:01:45Z
2013-01-01T00:00:00Z
2013-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.10/804
url http://hdl.handle.net/10400.10/804
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv J Med Cases. 2013;4(2):92-98
1923-4163
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elmer Press
publisher.none.fl_str_mv Elmer Press
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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