Abstract
Spontaneous bilateral rupture of the extensor mechanisms of the knees, without significant history of trauma, has been reported rarely, generally in association with chronic metabolic disorders, such as chronic renal failure and secondary hyperparathyroidism. We report spontaneous tendon rupture in two patients on chronic hemodialysis for 4 and 11 years, with documented severe secondary hyperparathyroidism. One patient had spontaneous bilateral rupture of his quadriceps and partial avulsion of the left triceps tendons. The other patient had spontaneous rupture of his right quadriceps tendon. Both patients had markedly elevated serum intact parathyroid hormone and moderately elevated serum β2-microglobulin levels. Pathologic examination revealed diffuse immunohistochemical staining for β2,-microglobulin but negative Congo-red staining of the ruptured tendon specimens. These cases and the previous reports in the literature suggest that secondary hyperparathyroidism may play a role in the pathogenesis of this clinical entity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 951-955 |
| Number of pages | 5 |
| Journal | American Journal of Kidney Diseases |
| Volume | 24 |
| Issue number | 6 |
| DOIs | |
| State | Published - 1994 |
Funding
From the Division of Nephrology. St Louis University Health Sciences Center. St Louis. MO. Received March 3, 1994; accepted in revised foml July 18. 1994. Supported in part by an extramural grant from Baxter Health Care Corporation to Dr Bastani. Address reprint requests to Bahar Bastani. MD. Division of Nephrology, St Louis University Health Sciences Center. 3635 Vista Ave, 9N FDT. St Louis, MO 63110. © 1994 by the National Kidney Foundation. Inc. 02 72-6386/9412406-0013$3.00/0
Keywords
- Hemodialysis
- end-stage renal disease
- hyperparathyroidism
- tendon rupture
- β -microglobulin
ASJC Scopus subject areas
- Nephrology