Sclerochoroidal calcification: idiopathic or associated with systemic disease?

BACKGROUND: Idiopathic sclerochoroidal calcification is a rare disorder that may be confused with a malignant tumor. In most patients, its etiology is unknown. Some patients have associated systemic disorders or syndromes.

METHODS: We report the case history of a patient with hypercalcemia and extensive sclerochoroidal calcifications; furthermore, we evaluate a series of seven patients with sclerochoroidal calcification, investigating calcium-phosphorus metabolism and screening for primary renal tubular hypokalemic metabolic alkalosis syndromes.

RESULTS: One patient was diagnosed with bilateral sclerochoroidal calcification; she had primary hyperparathyroidism due to a parathyroid adenoma. None of the other seven patients met the criteria of primary renal tubular hypokalemic metabolic alkalosis syndromes or had significant problems of calcium-phosphorus metabolism. Nevertheless, two of them had a history of kidney stones, whereas two others had a history of arthritis.

CONCLUSION: For all patients with sclerochoroidal calcification, it is important to exclude primary renal tubular hypokalemic metabolic alkalosis syndromes such as Bartter and Gitelman syndromes, because these patients have a higher risk of cardiovascular morbidity especially during anesthesia.