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NDT Plus. 2010 Feb;3(1):64-7. doi: 10.1093/ndtplus/sfp115. Epub 2009 Sep 9.

Ectopic ossification in the cranial dura mater in dialysis patients with secondary hyperparathyroidism.

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Division of Nephrology , Joetsu General Hospital , Joetsu.
Division of Clinical Nephrology and Rheumatology , Niigata University Graduate School of Medical and Dental Sciences , Niigata.
Division of Brain Surgery , Joetsu General Hospital , Joetsu , Japan.


We report the case of a 69-year-old woman with secondary hyperparathyroidism who underwent maintenance haemodialysis therapy for 17 years and who presented with severe dural calcification and right subdural haematoma. Her dura mater displayed a rock barnacle-like appearance, and cerebral superficial arteries adhered to the sclerotic lesions. On the microscopic observation, calcified tissue with a clear lamellar structure and osteopontin immunoreactivity was observed. Tartrate-resistant acid phosphatase immunoreactive polynucleated giant cells infiltrated around the tissue. Such morphological properties are specific to the calcified tissue formed through a bone formation-like mechanism that is often observed in arterial media in patients with chronic kidney disease.


dura matter; ectopic ossification; secondary hyperparathyroidism; subdural haematoma; tartrate-resistant acid phosphatase

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