Calcitriol/calcium carbonate
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Acute calcific epicondylitis: case report A 33-year-old man developed acute calcific epicondylitis during treatment with calcium carbonate and calcitriol for hypocalcaemia. The man presented with acute left elbow pain and swelling. Several months prior to the presentation, he had a similar attack. The elbow x-ray demonstrated two hyperdense calcifications at the lateral epicondyle. An ultrasound revealed hyperechoic deposits over the lateral epicondyle with increased Doppler activity, confirming the diagnosis of lateral calcific epicondylitis. It was found that he had been receiving calcium carbonate 1250mg three tablets three times daily and calcitriol 1 µg/day following the diagnosis of primary hypoparathyroidism characterised by hypocalcaemia and low parathyroid hormone. His serum calcium was maintained by calcitriol 1 µg/day [route not stated] and calcium carbonate 1250mg three tablets three times daily. Just prior to the presentation, he developed a foreign body sensation on swallowing, and a CT scan of the neck revealed a tiny hyper-density calcification along the posterior surface of the soft palate. Based on the presenting symptoms and findings, he was diagnosed with acute calcific epicondylitis [durations of treatments to reaction onset not stated]. The man received treatment with celecoxib for 5 days with a good response. All his previous calcium levels were on the low normal range and a 24-hour urine calcium was found to be elevated. He was then referred to an endocrinologist for consideration for parathyroid hormone replacement therapy. Awadh B, et al. Acute calcific epicondylitis associated with primary hypoparathyroidism: A paradox effect or an adverse event. Rheumatology 59 (Suppl. 2): ii134 abstr. 803507476 EP08, Apr 2020. Available from: URL: http://doi.org/10.1093/rheumatology/keaa109.007 [abstract]
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Reactions 17 Oct 2020 No. 1826
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