Genu valgum bilatéral pathologique dans un contexte d’hyperparathyroïdie secondaire à une maladie rénale chronique

Mineral bone disorders are common in patients with chronic kidney disease, particularly in hemodialysis patients. We report the case of a 21-year-old patient who has been chronically hemodialysed for 5 years for end-stage renal disease. While the initial nephropathy is undetermined, the patient has developped for the past 3 years, a progresssively worsening genu valgum with an inter-malleolar distance of 10 cm. Standard radiography of the lower limbs showed bone demineralization. There were no calcifications on blood vessels. Cardiac Doppler and supra-aortic trunk Doppler showed valvular and vascular calcifications. The biological check-up found secondary hyperparathyroidism with an intact parathormone at 910 pg/mL. A subtotal para-thyroidectomy was performed in January 2019. Pathological examination showed glandular hyperplasia. The evolution has been favorable and orthopedic management may be considered to correct the genu valgum. This is a rare case of late osteo-articular deformation in association with hyperparathyroidism secondary to renal failure. Etiological management was performed after the deformation was installed. Hence, this complication shows the interest of pre-emptive management of patients with chronic kidney disease. Received: April 29th, 2021 Accepted: June 18th, 2021