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A case of bilateral Achilles tendon spontaneous rupture in a hemodialysis patient: Who is the real culprit? Acidosis? Or hyperparathyroidism?

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Case Report

Author Details : Saifullah Khan*, Muftah Othman, Mohammad Amin Elesnawy

Volume : 1, Issue : 2, Year : 2022

Article Page : 100-102

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Abstract

Patients who are on regular hemodialysis and who have advanced renal failure but have not yet started on renal replacement therapy have a high risk of tendon rupture, although this is a rare situation. We reported a case of 55-year-old male patient who had been on regular hemodialysis for the past 10 years. He presented with a sudden onset of pain and swelling in the left posterior ankle while climbing stairs. Ultrasonography revealed a complete disruption of the Achilles tendon, which was surgically repaired. His medical history was remarkable for the right Achilles tendon rupture a year ago. Investigations revealed tertiary hyperparathyroidism with chronic metabolic acidosis and high β-2 macroglobulin. With surgical repair, physiotherapy, and parathyroidectomy, the patient regained full active mobility. This case emphasized the importance of high parathyroid hormone level, metabolic acidosis, and high β-2 macroglobulin in the pathogenesis of tendons ruptures.

Keywords: Achilles tendon, Hemodialysis, High β-2 macroglobulin, Hyperparathyroidism, Rupture

How to cite : Khan S, Othman M, Elesnawy M A, A case of bilateral Achilles tendon spontaneous rupture in a hemodialysis patient: Who is the real culprit? Acidosis? Or hyperparathyroidism?. Yemen J Med 2022;1(2):100-102

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