Skip to main content

Advertisement

Log in

Severe maxillofacial renal osteodystrophy in two patients with chronic kidney disease

  • Case Report
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Renal osteodystrophy (ROD) is the bone pathology that occurs as an uncommon complication related to the several alterations in mineral metabolism present in patients with chronic kidney disease (CKD). This paper describes two cases of severe ROD affecting the maxilla and mandible and causing facial disfigurement of a young and a middle-aged female patient with CKD. Both patients had a history of secondary hyperparathyroidism, previously treated by surgery. The pathogenesis of the disease, as well as its clinical, imaging, and histopathological features, and management of the patient are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Antonelli JR, Hottel TL (2003) Oral manifestations of renal osteodystrophy: case report and review of the literature. Spec Care Dentist 23(1):28–34

    Article  PubMed  Google Scholar 

  2. Collum J, Jones RHB, Liynham A, Hirst J (2013) Leontiasis ossea: a presentation of hyperparathyroidism in an indigenous Australian man secondary to chronic renal failure. J Oral Maxillofac Surg 71(1):56–61. doi:10.1016/j.joms.2012.04.008

    Article  PubMed  Google Scholar 

  3. Chauhan V, Kelepouris E, Chauhan N, Vaid M (2012) Current concepts and management strategies in chronic kidney disease-mineral and bone disorder. South Med J 105(9):479–485. doi:10.1097/SMJ.0b013e318261f7fe

    Article  PubMed  Google Scholar 

  4. Lim CY, Ong KO (2013) Various musculoskeletal manifestations of chronic renal insufficiency. Clin Radiol 68(7):e397–e411. doi:10.1016/j.crad.2013.01.025

    Article  CAS  PubMed  Google Scholar 

  5. Lerman MA, Do C, Gunaratnam L, Kulkarni C, Tucker K, Woo SB (2012) Localized mandibular enlargement in end-stage renal disease: two case reports and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 113(3):384–390. doi:10.1016/j.tripleo.2011.04.039

    Article  PubMed  Google Scholar 

  6. Damm DD, Neville BW, McKenna S, Jones AC, Freedman PD, Anderson WR et al (1997) Macrognathia of renal osteodystrophy in dialysis patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83(4):489–495

    Article  CAS  PubMed  Google Scholar 

  7. Chang JI, Som PM, Lawson W (2007) Unique imaging findings in the facial bones of renal osteodystrophy. Am J Neuroradiol 28(4):608–609

    CAS  PubMed  Google Scholar 

  8. Karsburg RM, Campos KR, Peres MPSM, Bologna SB, Lourenço SV, Franco JB (2012) Facial lesions caused by renal osteodystrophy in a patient with chronic renal insufficiency: a case report. Rev Odontol Cienc 27(2):161–165

    Article  Google Scholar 

  9. Fatahzadeh M (2011) The spectrum of orofacial manifestations in renal osteodystrophy: diagnostic challenges of an uncommon presentation. Quintessence Int 42(7):e78–e88

    PubMed  Google Scholar 

  10. Heymann EP, Jenkins M, Goldsmith D (2011) Clinical features and manifestations of CKD-MBD. Clin Rev Bone Miner Metab 10(3):142–148

    Article  Google Scholar 

  11. Way FM, Lessard M, Lafage-Proust MH (2012) Pathophysiology of chronic kidney disease-mineral and bone disorder. Joint Bone Spine 79(6):544–549

    Article  Google Scholar 

  12. Martin KJ, Olgaard K, Coburn JW, Coen GM, Fukagawa M, Langman C et al (2004) Bone Turnover Work Group: diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy. Am J Kidney Dis 43(3):558–565

    Article  PubMed  Google Scholar 

  13. Kalyvas D, Tosios KI, Leventis MD, Tsiklakis K, Angelopoulos AP (2004) Localized jaw enlargement in renal osteodystrophy: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97(1):68–74

    Article  PubMed  Google Scholar 

  14. Brooks JK, Rivera-Ramirez LE, Errington LW, Scheper MA (2011) Synchronous Paget disease of bone and hyperparathyroidism: report of a case with extensive craniofacial involvement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(4):e19–e24. doi:10.1016/j.tripleo.2010.11.004

    Article  PubMed  Google Scholar 

  15. Abdel Razek AA (2014) Computed tomography and magnetic resonance imaging of maxillofacial lesions in renal osteodystrophy. J Craniofac Surg 25(4):1354–1357. doi:10.1097/SCS.0000000000000819

    Article  PubMed  Google Scholar 

  16. Thomas R, Kanso A, Sedor JR (2008) Chronic kidney disease and its complications. Prim Care 35(2):329–344

    Article  PubMed Central  PubMed  Google Scholar 

  17. Morrow B, Qunibi W (2012) Specific bone and mineral disorders in patients with chronic kidney disease. Clin Rev Bone Miner Metab 10(3):184–208

    Article  Google Scholar 

  18. Adachi PLG, Santos PSS, Magalhães MHCG, Martins MT (2007) Renal osteodystrophy manifesting as localized enlargement of the jaw. Nephrol Dial Transplant 22:2398–2399. doi:10.1093/ndt/gfm232

    Article  CAS  PubMed  Google Scholar 

  19. Sagliker Y, Balal M, Ozkaynak PS, Paydas S, Sagliker C, Sagliker HS et al (2004) Sagliker syndrome: uglifying human face appearance in late and severe secondary hyperparathyroidism in chronic renal failure. Semin Nephrol 24(5):449–455

    Article  PubMed  Google Scholar 

  20. Yavascan O, Kose E, Alparslan C, Kose SS, Bal A, Kanik A et al (2013) Severe renal osteodystrophy in a pediatric patient with end-stage renal disease: Sagliker syndrome? J Ren Nutr 23(4):326–330. doi:10.1053/j.jrn.2012.07.002

    Article  PubMed  Google Scholar 

  21. Giray S, Sagliker Y, Yildiz I, Halvaci I, Paylar N, Ocal F et al (2006) Neurologic manifestations in Sagliker syndrome: uglifying human face appearance in severe and late secondary hyperparathyroidism in chronic renal failure patients. J Ren Nutr 16(3):233–236

    Article  PubMed  Google Scholar 

  22. Malluche HH, Mawad HW, Monier-Faugere MC (2011) Renal osteodystrophy in the first decade of the new millennium: analysis of 630 bone biopsies in black and white patients. J Bone Miner Res 26(6):1368–1376. doi:10.1002/jbmr.309

    Article  PubMed Central  PubMed  Google Scholar 

  23. Conti-Freitas LC, Foss-Freitas MC, Lucca LJ, da Costa JA, Mamede RC, Foss MC (2009) Dynamics of parathyroid hormone secretion after total parathyroidectomy and autotransplantation. World J Surg 33(7):1403–1407. doi:10.1007/s00268-009-0057-8

    Article  PubMed  Google Scholar 

  24. Adornato MC, Mayne RW (2000) Macrognathia of renal osteodystrophy in a dialysis patient. Report of a case. N Y State Dent J 66(10):30–34

    CAS  PubMed  Google Scholar 

  25. Hata T, Irei I, Tanaka K, Nagatsuka H, Hosoda M (2006) Macrognathia secondary to dialysis-related renal osteodystrophy treated successfully by parathyroidectomy. Int J Oral Maxillofac Surg 35(4):378–382

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maria Luiza Diniz de Sousa Lopes.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lopes, M.L.D.d.S., Albuquerque, A.F.M., Germano, A.R. et al. Severe maxillofacial renal osteodystrophy in two patients with chronic kidney disease. Oral Maxillofac Surg 19, 321–327 (2015). https://doi.org/10.1007/s10006-015-0490-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-015-0490-9

Keywords

Navigation