Karishma
A case of bilateral achilles tendon spontaneous rupture in a hemodialysis patient: who is the real culprit? acidosis? or hyperparathyroidism?
Journal title : Yemen Journal of Medicine
Publisher : Mansa STM Publishers
Online ISSN : 2583-4614
Page Number : 100-102
Journal volume : 1
Journal issue : 2
19 Views Case Report
Patients who are on regular hemodialysis and who have advanced renal failure but have not yet started on renal replacement therapy have a high risk of tendon rupture, although this is a rare situation. We reported a case of 55-year-old male patient who had been on regular hemodialysis for the past 10 years. He presented with a sudden onset of pain and swelling in the left posterior ankle while climbing stairs. Ultrasonography revealed a complete disruption of the Achilles tendon, which was surgically repaired. His medical history was remarkable for the right Achilles tendon rupture a year ago. Investigations revealed tertiary hyperparathyroidism with chronic metabolic acidosis and high β-2 macroglobulin. With surgical repair, physiotherapy, and parathyroidectomy, the patient regained full active mobility. This case emphasized the importance of high parathyroid hormone level, metabolic acidosis, and high β-2 macroglobulin in the pathogenesis of tendons ruptures.
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DOI : https://doi.org/10.32677/yjm.v1i2.3642
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