Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 4, Number 2, February 2013, pages 92-98

Reversible Myocardial Calcification Following Severe Leptospirosis Complicated With Rhabdomyolysis-Induced Acute Kidney Injury and Magnesium-Wasting Nephropathy

Figures

Figure 1.
Figure 1. Evolution of serum calcium, phosphorus, magnesium, creatinine and albumin levels during the hospital stay and first weeks after discharge.
Figure 2.
Figure 2. A: Chest x-ray: Linear calcification on the left border of the cardiac silhouette. B: CT scan: Calcification of left ventricle, parts of right ventricle, and interventricular septum. C: CT scan by the 18th month after discharge: Progressive resorption of calcific deposits in the heart. D: CT scan by the 36th month after discharge: Only millimetric calcification in the left ventricle.

Table

Table 1. Laboratory Evaluation Results
 
1st month (after IHD stopped)18th month36th month
Abbreviations used: UNa, urine sodium; Uk, urine potassium; UCa, urine calcium; UMg, urine magnesium; FEMg, fractional excretion of magnesium. Normal Values: creatinine (0.85 - 1.3 mg/dL), sodium (135 - 148 mmol/L), potassium (3.5 - 5.3 mmol/L), calcium (8.5 - 10.1 mg/dL), magnesium (1.8 - 2.4 mg/dL), UNa (40 - 220 mmol/day), Uk (25 - 125 mmol/day), UCa (42 - 353 mg/day), UMg (24 - 225 mg/day), FEMg < 2.2%.
pH (arterial)7.439-7.425
(HCO3-) (mmol/L)24.4-27.8
pCO2 (mmHg)36.9-43.3
Creatinine (mg/dL)0.71.00.9
Sodium (mmol/L)136137137
Potassium (mmol/L)4.14.74.5
Calcium (mg/dL)10.19.89.6
Magnesium (mg/dL)1.41.71.9
UNa (mmol/day)/FENa (%)-256/0.9%191/0.6%
Uk (mmol/day)/FEK (%)-108/10.8%60/5.8%
UCa (mg/day)556200165
UMg (mg/day)501183107
FEMg (%)31%6.8%2.0%
PTH (pg/mL)34.6--