NEPHROCALCINOSIS VISIBLE BY X-RAY ASSOCIATED WITH CHRONIC GLOMERULONEPHRITIS

Abstract

Four unusual cases of nephrocalcinosis were presented, all associated with chronic glomerulonephritis. In 3 of these cases the calcification seen in X-ray films was confined mostly to the renal cortex and resulted in a striking roentgenographic picture, while in the 4th patient the calcification seen by X-ray was diffusely distributed throughout the entire kidney, although it was mostly in the cortex on histo-logic examination. This latter case (case 4), however, exhibited clinical and pathologic findings in addition to chronic glomerulonephritis which set it apart from the other 3 cases and may have explained its differing X-ray appearance. In 3 of the 4 cases, as in the 2 cases previously reported, there was a history of excessive Ca ingestion which may have provided an additional etiologic factor in the calcification process. Nephrocalcinosis involving mainly the renal cortex strongly suggests an underlying chronic glomerulonephritis, since we have noted no other disorder which is associated with this roentgen pattern of renal calcification. By contrast with chronic glomerulonephritis, other disorders associated with nephrocalcinosis[long dash]such as hyperpara-thyroidism, hyperchloremic acidosis, vitamin D intoxication and sarcoidosis, all of which have in common increased Ca excretion in the urine[long dash]result in Ca deposition which by X-ray examination is more marked in the medually pyramids. This distribution also results in a strikingly typical roentgenographic picture.