Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethylmethacrylate (PMMA)

Abstract Cosmetic injections of fillers are common plastic surgery procedures worldwide. Polymethylmethacrylate (PMMA) is a filler approved only for minimally invasive procedures in facial tissue and is among the most frequently used injectable substances for cosmetic purposes. Injection of a large volume of PMMA may lead to the development of severe hypercalcemia and chronic kidney damage in a probably underestimated frequency. In such cases, hypercalcemia develops due to a granulomatous foreign body reaction with extrarenal production of calcitriol. In the present report, we describe the cases of two patients who received injections of large volumes of PMMA and developed severe hypercalcemia and advanced chronic kidney disease. These reports highlight the importance of adhering to regulations regarding the use of PMMA and properly informing patients of the possibility of complications before undertaking such procedures.

摘要：美容填充注射是全球范围内常见的整形外科手术。聚甲基丙烯酸甲酯（Polymethylmethacrylate，PMMA）是仅获批用于面部组织微创操作的填充剂，也是美容领域最常用的注射用物质之一。大剂量注射PMMA可能引发严重高钙血症与慢性肾损伤，其发生频率或被低估。此类病例中，高钙血症的发病机制为肉芽肿性异物反应伴随骨化三醇的肾外生成。本报告将介绍两例接受大剂量PMMA注射后出现严重高钙血症与晚期慢性肾脏病的患者病例。本病例报告凸显了严格遵守PMMA使用相关法规的重要性，同时强调在开展此类操作前，需向患者充分告知并发症发生的可能性。