Regression of uremic tumoral calcinosis following the switch from cinacalcet to etelcalcetide in a hemodialysis patient without severe hyperphosphatemia.
Takuya Hase, Shunsuke Goto, Hitomi Hara et al.
✦ AI-curated · Sources linked
Case in brief
A 46-year-old man receiving maintenance hemodialysis developed progressive peri-articular soft-tissue calcifications that became tumoral calcinosis (TC), involving both thighs and the left elbow and causing a left femoral shaft fracture. At referral, serum phosphate was 4.9 mg/dL, corrected calcium 10.3 mg/dL, and intact parathyroid hormone 109 pg/mL; severe hyperphosphatemia was absent. After cinacalcet was switched to intravenous etelcalcetide hydrochloride, the remaining TC showed significant regression six months later.
What made this case unusual
The TC regressed after the switch to etelcalcetide despite the absence of severe hyperphosphatemia, a metabolic abnormality commonly implicated in uremic TC.
Diagnostic / clinical pearl
In a hemodialysis patient with peri-articular calcified masses, consider uremic tumoral calcinosis even without severe hyperphosphatemia; this case documents regression after switching from cinacalcet to etelcalcetide.
Why it matters
The observation suggests etelcalcetide may be useful in this setting, but a single case cannot establish whether the response is generalizable.