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Evaluation of Oxalate Osteopathy Secondary to Hyperoxaluria With 18F-FDG PET/CT and 99mTc-HMDP Bone Scan

Somme, François, MD*; Blondet, Cyrille, MD*†‡; Matuszak, Julien, MD*‡; Heimburger, Céline, MD*†‡

doi: 10.1097/RLU.0000000000002386
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We report a case of a 69-year-old woman with primary hyperoxaluria type I, who developed a severe hypercalcemia despite controlled secondary hyperparathyroidism. Bone scintigraphy showed diffuse increased uptake in axial and peripheral skeleton. 18F-FDG PET/CT showed countless striking hypermetabolic foci, interesting 2 types of lesions (joint calcifications and periosteal resorptions). Bone biopsy demonstrated inflammatory changes around many calcium oxalate crystals; hypercalcemia was then related to oxalate osteopathy. Immunotherapy with denosumab was thus initiated. Eighteen months later, a second PET/CT showed decreased 18F-FDG uptake, reflecting treatment efficacy on inflammatory reaction secondary to calcium oxalosis skeletal deposits.

From the *Service de Biophysique et de Médecine Nucléaire, Hôpitaux Universitaires de Strasbourg;

ICube, Université de Strasbourg/CNRS UMR 7357; and

Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Strasbourg, France.

Received for publication June 12, 2018; revision accepted October 9, 2018.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Céline Heimburger, MD, Service de Biophysique et de Médecine Nucléaire, Hôpital de Hautepierre, 1, Ave Molière, 67200 Strasbourg Cedex, France. E-mail: celine.heimburger@chru-strasbourg.fr.

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