calcification (calcification) - is a common limited accumulation of calcium in the form of salts in the structure of different tissues with subsequent pathological changes in their function.If a satisfactory functioning of the digestive tract and urinary system provides normal metabolic calcium exchange in the form of its absorption in the small intestine and excretion in the feces and urine.
-mediated regulation of calcium metabolism is carried out through the allocation of parathyroid hormone substances enhancing or inhibiting the processes of absorption and excretion of calcium, as well as its accumulation of salts in the blood or bone tissue (calcification, hypercalcemia, osteoporosis).
In a situation where a person says generalized accumulation of calcium salts in a particular tissue due to common metabolic disorders, experts establish the conclusion "metastases lime type."The formation of metastases contributes to increased lime leaching of calcium from the bone observed
limited accumulation of calcium in any area of healthy tissue is not due to systemic disorders of mineral metabolism, you should assume the presence of dystrophic calcification type.Not necessarily, even pronounced calcification is burdening the health status of the patient, such as tuberculous lesion signs of calcification indicative of the transition to the period of convalescence.
The basis of the pathogenetic mechanism of calcification any location put the transition from a soluble calcium liquid to excessive accumulation of salts in its tissues of the human body.This pathological condition may develop as a result of a plurality of trigger factors, but the starting mechanism of calcification is a failure of metabolism of calcium in the body.
most often calcium metabolism is disturbed due to improper function of regulating the hormonal substances produced by the parathyroid glands, resulting in various endocrinopathy.In addition, the process of absorption and utilization of calcium salts affects the level of calcium in the blood, which may vary considerably in upward and a sharp decline.In the process of the exchange reactions of calcium participates a great number of enzymes, so the presence of a person fermentopathy conditions for its excessive accumulation of salts in the body.
There are different categories of precipitating factors affecting the development of signs of calcification, which can be divided into exogenous and endogenous.Exogenous causes calcification should include different kinds of injuries of bones and soft tissues, as well as excessive intakes of vitamin D group, there has been a failure to comply with the dosage of the drug in pediatric patients.Endogenously are internal pathological conditions of the human body, accompanied by systemic metabolic disorders, not only calcium, but other minerals (polycystic, kidney disease, multiple myeloma, malignant neoplasms, endocrinopathies).
good substrate for the excessive accumulation of calcium is a connective scar tissue, so any pathological changes in the organs, accompanied by the growth of fibrous tissue, sooner or later trigger calcification (valvular heart disease, atherosclerotic vascular changes, transplants).
Symptoms and signs of calcification
pathological calcification or calcification can manifest itself in several groups combined damage tissues and organs of the human body or limited to hit a particular structure.Each of the forms of calcification has specific clinical and laboratory-instrumental signs, so should be considered variants of this disease according to the localization of lesions.
As a secondary localization process of calcification is considered calcification of the skin, as it contributes to the emergence of pre-accumulation of calcium in the parenchyma of internal organs, followed by excessive intake of calcium in the soft tissue.The main source of "abnormal calcium" are the calcified kidneys.In rare cases, the disease process is localized primarily in the skin and its further distribution of developing tendon calcification.
development of calcification of vascular diseases contribute to the character and variety of collagen in which there is an excessive proliferation of interstitial component.The initial manifestations of cutaneous calcification do not worsen the patient's condition and have only a cosmetic defect in the form of the emergence of many solid nodules, painless to palpation, with no signs of inflammation preferentially localized in the projection of the distal extremities.
appearance of inflammatory changes in calcification is accompanied by the formation of a fistula with purulent contents, as well as a regional soft tissue swelling.Calcification of the skin can occur as a limited and common form, occupying a large part of the surface of the skin.The most informative way to establish a definite diagnosis is histological examination of biomaterial containing a portion of calcification.
development characteristics excessive calcium accumulation may occur at any age period, in healthy humans, and at various pathologies.A separate form of this disease, which requires attention to the impact is the calcification of the placenta, which in most cases is accompanied by complications of pregnancy and refers to one of the criteria for the development of placental insufficiency.Pathogenesis of matochnoplatsentarnoy failure is in violation of the blood supply and oxygen-rich nutrients from the lumen of the obturating placental vascular bundle calcifications large.However, in some cases, the presence of foci of calcification in the placenta does not have a significant impact on the normal development of the fetus, so this deviation does not require specific treatment and must be extremely dynamic ultrasound monitoring.
development of calcification of the placenta helps transferred history urogenital infection, unbalanced diet food a pregnant woman, as well as perenashivanie pregnancy.Thus, signs of calcification of the placenta is not an adverse prognostic indicator and is regarded as a risk factor, provoking matochnoplatsentarnuyu failure in combination of other predisposing factors.
During the ultrasound examination of a pregnant woman, even the detection of single calcifications should be reflected in the final minutes of the survey, as provided to other changes in the thickness, size, presence of calcifications contours placenta is seen as an indirect sign of "premature aging of the placenta."
It should be noted that the appearance of calcifications in the uterus can be triggered not only burdened by pregnancy and the presence of calcifications of the placenta during pregnancy.Calcification of the uterus in most cases is the result of a residual phenomenon or suffering of any inflammatory process, localized in the endometrium and myometrium.No exception is the appearance of calcifications in existing myoma nodes, which is a poor prognostic sign and an indication for surgical treatment.
Effect of calcification on the health of the male genitalia radically opposite, since the presence of calcifications in the prostate gland is considered an unfavorable sign of possible complications in the form of various inflammatory diseases.The structure of the prostate is a favorable substrate for the accumulation of calcium salts, since it emits thick secretion comprising mucous component.In addition, if the patient has signs of uretero-prostate reflux in 90% of cases triggers prostate calcification.
With widespread calcified lesion with most of the internal organs, the spleen can be observed calcification, which is detected by screening ultrasound, and has no specific clinical manifestations.
calcification of the aorta and aortic valve
According to most theories and research, calcification of the aorta in the isolated form is extremely rare, but if it does, it fast enough patient develops calcifying valvular.Signs of aortic valve calcification patterns in the patient over time leads to pronounced hemodynamic disorders and diseases of the organic nature (myocardial infarction, chronic heart failure).
Most often calcifying aortic valve develops on the basis of existing degenerative changes of rheumatic nature.Flabby, welded together valve flaps are a substrate for the formation of lime shapeless outgrowths that cover the lumen of the aorta.With long-term course of the disease the pathological process of calcification spreading to nearby structures and developing mitral calcification.
diagnosis of aortic valve calcification in most situations does not make difficulties with the application of high-quality X-ray and ultrasound equipment.At the same foci of calcification are areas of high density, with clear contours in the form of solitary or multiple production.
In a situation where the process of calcification extends to the interventricular septum and mitral valve reaches develops calcification of the mitral valve.These lesions do not show specific clinical and laboratory symptoms and are diagnosed only with the help of instrumental methods of visualization.The delay in establishing the correct diagnosis inevitably leads to the development of coarse heart defects with severe hemodynamic disorders that significantly impairs quality of life and reduces life expectancy.Subject to early diagnosis and timely surgical correction of the defect, there comes a restoration of normal cardiac function and a significant improvement in patient well-being.
The examination of the patient by echocardiography should be aware that the process of calcification may affect not only the heart valve, but also to spread the myocardium in physiological chords and be called "calcification of the heart."This localization of the pathological process of calcification of dangerous complications, comprising sudden damage the endothelium and associated valve thrombosis.The risk of thrombosis is the rapid progression and development tromboendokardita signs of generalized sepsis.
In principle Etiopatogenetichesky intraatrial calcification can be divided into primary, which is a physiological manifestation of aging, and the secondary, which is the agent provocateur of a chronic disease process in the body (heart disease, metabolite disorders, endocrinopathies).Calcification intracardiac localization accompanied by clinical symptoms only in the late stage of the disease, when the processes of calcification have a negative impact on cardiohemodynamics.In this case, the patient can be confusing for recurrent heart rhythm disruptions, cardialgia and dizziness.The emergence of progressive shortness of breath indicates the presence of the patient's extreme intracardiac calcification in need of immediate surgical correction.
advanced or localized parietal accumulation of calcium in the vascular interstitial causes disruption of blood flow and the occurrence of hemodynamic disturbances in various organs.Pronounced changes in humans provokes widespread calcification of the arteries of large caliber, which becomes the cause of ischemic damage to vital structures.The prevalence of a mechanism for the formation of calcification in the lumen of blood vessels triggers the development of calcifications in several variants (metastatic, dystrophic and interstitial).There is also a separate category intravascular calcifications, which debuts in the children's age period and the reason for its occurrence is considered to be congenital abnormalities of the vasculature.
most severe and dangerous form of intravascular calcification is abdominal aortic calcification which leads to development of aneurysms.The danger of this disease lies in its latent clinical course and the simultaneous threat of a massive intra-abdominal haemorrhage in violation of the integrity of the vascular wall.In the case of timely diagnosis of abdominal aortic calcification in the stage of formation of an aneurysm, the patient in the shortest time necessary to perform resection of the altered portion of the aorta, followed by plastics defect.
calcification of the kidneys (nephrocalcinosis)
When excess of calcium in the human body, or violation of its metabolic transformations, the conditions for an excessive accumulation of salts in its tissues of parenchymal organs and kidneys in this situation is no exception.As a rule, nephrocalcinosis is a diffuse process of calcification combined with inflammatory changes of the renal parenchyma, which in the long course inevitably provokes the development of signs of renal failure.
As with other forms of calcification, nephrocalcinosis may develop on the background of an unchanged the renal parenchyma or renal absolutely unchanged.The primary form of nephrocalcinosis is not a separate disease entities, and the mechanism of its development is based on the excess of calcium entering the body with food, medicines, as well as a violation of the common endocrinopathy of calcium metabolism in the parathyroid glands.The substrate for the development of secondary necrotic changes is nephrocalcinosis renal parenchyma, ischemic kidney damage and kidney have been exposed to radiation.
When unmodified calcium metabolism, the process of removing it from the body rests the responsibility of the organs of the urinary system, but in excess of its content in the kidneys are not able to devote a sufficient amount of calcium in the urine, resulting in its accumulation in the cells of the renal parenchyma.In the initial phase of the disease, the excess calcium is deposited only in the epithelial cells of the tubules, and prolonged during the process of calcification is observed in the lumen of the renal tubules.In a situation where calcareous layers completely occlusive lumen of tubules, the patient has signs of uriniparous urinary and renal function.The final step is the development of calcification of the kidneys nephrosclerosis with concomitant renal insufficiency.
Given the total absence of timely diagnosis and treatment of calcification of the kidneys, the disease progresses and is accompanied by inflammatory changes and the development of kidney stones.Unfortunately, the specific manifestations of nephrocalcinosis was observed in patients only in the terminal stage of the disease and is increasingly characterized by the development of renal failure (pronounced edema syndrome, malignant hypertension, difficulty urinating).
most informative diagnostic method to determine nephrocalcinosis in the initial phase of the pathological process is aiming needle biopsy, the use of which is not a screening algorithm patient.