Intense myocardial and lung uptake of 99m-Tc-pyrophosphate using single photon emission computed tomography in a patient with end-stage renal disease and secondary hyperparathyroidism

Metastatic calcification, a frequent and potential lethal complication of chronic renal failure, is rarely detected before death because of the absence of specific radiographic abnormalities. We report the case of a patient on haemodialysis, with secondary hyperparathyroidism and a second degree A-V block who had a 99m-Tc-pyrophosphate scan to rule out myocardial infarction. The scintigram showed marked myocardial and lung uptake that is indicative of severe metastatic hydroxy-apatite calcifications.