[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-456062-105":59,"doc-detail-456062-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","a-patient-with-polyuria-and-polydipsia-following-silicone-injections","A Patient with Polyuria and Polydipsia Following Silicone Injections","","A 52-year-old transgender woman with asthma, hypertension, and prior silicone gluteal injections developed polyuria, polydipsia, and constipation with marked hypercalcemia, renal dysfunction, and vitamin D/PTH axis abnormalities. Imaging demonstrated extensive calcified granulomas within injected gluteal subcutaneous fat and muscles, and workup suggested granulomatous disease. Treatment with IV fluids, zoledronic acid, and calcitonin achieved initial improvement, followed by denosumab and a prednisone trial. Despite prolonged therapy, intermittent severe hypercalcemia recurred, causing nephrolithiasis, hydronephrosis, and progression to CKD stage 4.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-patient-with-polyuria-and-polydipsia-following-silicone-injections/456062/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-patient-with-polyuria-and-polydipsia-following-silicone-injections/456062.png","ImageObject",300,407,{"name":92,"@type":93},"Terk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What symptoms did the patient present with after silicone injections?","Question",{"text":112,"@type":113},"She presented with polyuria, polydipsia, and constipation alongside significant hypercalcemia and kidney impairment.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did the diagnostic workup and imaging show?",{"text":117,"@type":113},"Workup showed abnormal calcium, vitamin D, and parathyroid hormone-related findings, and CT/bone scan demonstrated calcified granulomas throughout the bilateral gluteal injected tissues.",{"name":119,"@type":110,"acceptedAnswer":120},"Why did the patient’s condition worsen despite treatment?",{"text":121,"@type":113},"Granulomatous tissue reactions to deposited silicone likely drove ongoing excess 1,25-dihydroxyvitamin D production and recurrent hypercalcemia, leading to recurrent nephrolithiasis, hydronephrosis, and CKD progression.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},456062,1790795783,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},1099525198933,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","A Patient with Polyuria and Polydipsia Following Silicone Injections  \nValeria De la Pena  , 1,2 Celine Garcia  , 1,2 and Danny Haddad2  \nKidney360 6: 1826–1827, 2025. doi: [https://doi.org/10.34067/KID.0000000817](https://doi.org/10.34067/KID.0000000817)  \nCase Description  \nA 52-year-old transgender woman with a medical history of asthma, hypertension, and silicone injections in the glutes presented with polyuria, polydipsia, and constipation. Bloodwork showed serum calcium of 16 mg/dl, BUN 38 mg/dl, and serum creatinine 2.03 mg/dl. Further workup revealed low parathyroid hormone 6.3 pg/ml, low parathyroid hormone-related-peptide 16 pg/ml, low 25-hydroxyvitamin D 15 ng/ml, and elevated 1,25-dihydroxyvitamin D 66 pg/ml. The patient was treated with intravenous fluids, zoledronic acid, and calcitonin for 5 days and discharged on alendronate 70 mg weekly. Four months later, the patient was hospitalized with symptomatic hypercalcemia. Further workup revealed negative serum protein electrophoresis and immunofixation, elevated lactate dehydrogenase 234 U/L, and elevated angiotensin converting enzyme levels 162.9 U/L, suggesting granulomatous disease. A computed tomography scan of the  \nabdomen/pelvis showed infiltration throughout the bilateral gluteal subcutaneous fat with scattered calcified granulomas (Figure 1, A and B) . A bone scan showed diffuse radionuclide accumulation in the glutes, corresponding with soft tissue attenuation and scattered calcifications. She was then started on denosumab 120 mg monthly with modest improvement in serum calcium levels. She also underwent a 4-month trial of prednisone 10 mg daily, during which no significant decrease in calcium was noted and kidney function persistently declined, which is the reason why it was discontinued. The patient continued on denosumab for 2 years; unfortunately, she continued having episodes of intermittent severe hypercalcemia, leading to recurrent nephrolithiasis and hydronephrosis, which further compromised the kidney function. Serum calcium levels began to stabilize by the third year of treatment; unfortunately, this coincided with the patient progressing to CKD stage 4.  \nA  \nB  \nFigure 1. Calcified granulomas on silicone injections. CT scan of the abdomen and pelvis shows scattered calcified granulomas throughout the bilateral gluteal subcutaneous fat and muscles on coronal (A) and axial (B) images. CT, computed tomography.  \n1Rutgers Health, Newark, New Jersey  \n2Jersey City Medical Center, Jersey City, New Jersey  \nCorrespondence: Dr. Valeria De la Pena, email: [valeria.delapena@rutgers.edu](valeria.delapena@rutgers.edu)  \nCopyright © 2025 The Author(s) . Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \n1826 [www.kidney360.org](www.kidney360.org Vol)[ Vol](www.kidney360.org Vol) 6 October, 2025  \nDiscussion  \nThis case underscores the importance of considering rare causes of recurrent hypercalcemia, such as tissue reactions with multiple granuloma formation associated with silicone injections. Granuloma formation due to the deposited silicone is associated with hypercalcemia, which can lead to prolonged hypercalciuria and CKD.1 An immune reaction to silicone leads to hypercalcemia by increasing calcium absorption through the production of 1,25 vitamin D3 .2 In addition to the therapies provided in this case, normalization of serum calcium could be related to the development of advanced CKD. Owing to the challenge of removing extensive granulomas, the development of alternative management strategies to lower serum calcium is crucial.  \nTeaching Points  \nc There is a significant association between silicone implants and hypercalcemia due to granulomatous reaction.  \nMacrophage activation in granulomas lead","cbCaieuTBhy8ZvKz","https://ap.wps.com/l/cbCaieuTBhy8ZvKz","pdf",241674,"English","# Case Description\n# Discussion\n# Teaching Points\n# Disclosures\n# Acknowledgments\n# Author Contributions\n# References","[{\"question\":\"What symptoms did the patient present with after silicone injections?\",\"answer\":\"She presented with polyuria, polydipsia, and constipation alongside significant hypercalcemia and kidney impairment.\"},{\"question\":\"What did the diagnostic workup and imaging show?\",\"answer\":\"Workup showed abnormal calcium, vitamin D, and parathyroid hormone-related findings, and CT/bone scan demonstrated calcified granulomas throughout the bilateral gluteal injected tissues.\"},{\"question\":\"Why did the patient’s condition worsen despite treatment?\",\"answer\":\"Granulomatous tissue reactions to deposited silicone likely drove ongoing excess 1,25-dihydroxyvitamin D production and recurrent hypercalcemia, leading to recurrent nephrolithiasis, hydronephrosis, and CKD progression.\"}]","A Patient with Polyuria and Polydipsia Following Silicone Injections | PDF",1790745035]