Calcification is the accumulation of

calcium Calcium is a chemical element with the symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar to ...

salts in a

body tissue In biology, tissue is a biological organizational level between cells and a complete organ. A tissue is an ensemble of similar cells and their extracellular matrix from the same origin that together carry out a specific function. Organs are ...

. It normally occurs in the formation of

bone A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...

, but calcium can be deposited abnormally in

soft tissue Soft tissue is all the tissue in the body that is not hardened by the processes of ossification or calcification such as bones and teeth. Soft tissue connects, surrounds or supports internal organs and bones, and includes muscle, tendons, ligam ...

,Miller, J. D. Cardiovascular calcification: Orbicular origins. ''Nature Materials'' 12, 476-478 (2013). causing it to harden. Calcifications may be classified on whether there is mineral balance or not, and the location of the calcification. Calcification may also refer to the processes of normal mineral deposition in biological systems, such as the formation of

stromatolite Stromatolites () or stromatoliths () are layered sedimentary formations (microbialite) that are created mainly by photosynthetic microorganisms such as cyanobacteria, sulfate-reducing bacteria, and Pseudomonadota (formerly proteobacteria). The ...

s or

mollusc shell The mollusc (or molluskOften spelled mollusk shell in the USA; the spelling "mollusc" are preferred by ) shell is typically a calcareous exoskeleton which encloses, supports and protects the soft parts of an animal in the phylum Mollusca, wh ...

s (see

Biomineralization Biomineralization, also written biomineralisation, is the process by which living organisms produce minerals, often to harden or stiffen existing tissues. Such tissues are called mineralized tissues. It is an extremely widespread phenomenon; ...

Signs and symptoms

Calcification can manifest itself in many ways in the body depending on the location. In the pulpal structure of a tooth, calcification often presents asymptomatically, and is diagnosed as an incidental finding during radiographic interpretation. Individual teeth with calcified pulp will typically respond negatively to vitality testing; teeth with calcified pulp often lack sensation of pain, pressure, and temperature.

Causes of soft tissue calcification

Calcification of soft tissue (arteries, cartilage,

heart valves A heart valve is a one-way valve that allows blood to flow in one direction through the chambers of the heart. Four valves are usually present in a mammalian heart and together they determine the pathway of blood flow through the heart. A heart v ...

, etc.) can be caused by vitamin K₂ deficiency or by poor

absorption due to a high calcium/vitamin D ratio. This can occur with or without a mineral imbalance. A common misconception is that calcification is caused by excess amount of calcium in

diet Diet may refer to: Food * Diet (nutrition), the sum of the food consumed by an organism or group * Dieting, the deliberate selection of food to control body weight or nutrient intake ** Diet food, foods that aid in creating a diet for weight loss ...

. Dietary calcium intake is not associated with accumulation of calcium in soft tissue, and calcification occurs irrespective of the amount of calcium intake. Intake of excessive

vitamin D Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects. In humans, the most important compounds in this group are vitamin D3 (c ...

can cause vitamin D poisoning and excessive intake of calcium from the intestine, when accompanied by a deficiency of vitamin K (perhaps induced by an

anticoagulant Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where the ...

) can result in calcification of arteries and other soft tissue. Such metastatic soft tissue calcification is mainly in tissues containing "calcium catchers" such as elastic fibres or sour mucopolysaccharides. These tissues especially include the lungs (pumice lung) and the aorta. Mineral balance *

Dystrophic calcification Dystrophic calcification (DC) is the calcification occurring in degenerated or necrotic tissue, as in hyalinized scars, degenerated foci in leiomyomas, and caseous nodules. This occurs as a reaction to tissue damage, including as a consequence o ...

, without a systemic mineral imbalance. *

Metastatic calcification Metastatic calcification is deposition of calcium salts in otherwise normal tissue, because of elevated serum levels of calcium, which can occur because of deranged metabolism as well as increased absorption or decreased excretion of calcium and re ...

, a systemic elevation of calcium levels in the blood and all tissues.

Forms

Calcification can be pathological or a standard part of the aging process. Nearly all adults show calcification of the

pineal gland The pineal gland, conarium, or epiphysis cerebri, is a small endocrine gland in the brain of most vertebrates. The pineal gland produces melatonin, a serotonin-derived hormone which modulates sleep, sleep patterns in both circadian rhythm, circ ...

Location

* Extraskeletal calcification, e.g.

calciphylaxis Calciphylaxis, also known as calcific uremic arteriolopathy (CUA) or “Grey Scale”, is a rare syndrome characterized by painful skin lesions. The pathogenesis of calciphylaxis is unclear but believed to involve calcification of the small blood ...

* Brain, e.g.

primary familial brain calcification Primary Indiana familial brain calcification Initial Posting: April 18, 2004; Last Update: August 24, 2017. (PFBC), also known as familial idiopathic basal ganglia calcification (FIBGC) and Fahr's disease, is a rare, genetically dominant, inher ...

(Fahr's syndrome) **

Choroid plexus The choroid plexus, or plica choroidea, is a plexus of cells that arises from the tela choroidea in each of the ventricles of the brain. Regions of the choroid plexus produce and secrete most of the cerebrospinal fluid (CSF) of the central nerv ...

usually in the

lateral ventricles The lateral ventricles are the two largest ventricles of the brain and contain cerebrospinal fluid (CSF). Each cerebral hemisphere contains a lateral ventricle, known as the left or right ventricle, respectively. Each lateral ventricle resemble ...

* Tumor calcification * Arthritic

bone spurs An exostosis, also known as bone spur, is the formation of new bone on the surface of a bone. Exostoses can cause chronic pain ranging from mild to debilitatingly severe, depending on the shape, size, and location of the lesion. It is most commonl ...

Kidney stones Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine s ...

Gall stones A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of mi ...

Heterotopic bone Heterotopic ossification (HO) is the process by which bone tissue forms outside of the skeleton in muscles and soft tissue. Symptoms In traumatic heterotopic ossification (traumatic myositis ossificans), the patient may complain of a warm, ten ...

Tonsil stones Tonsil stones, also known as tonsilloliths, are mineralizations of debris within the crevices of the tonsils. When not mineralized, the presence of debris is known as chronic caseous tonsillitis (CCT). Symptoms may include bad breath. Generall ...

Pulp stone Pulp stones (also denticles or endoliths) are nodular, calcified masses appearing in either or both the coronal and root portion of the pulp organ in teeth. Pulp stones are not painful unless they impinge on nerves. They are classified: :A) On th ...

Breast disease

In a number of breast pathologies, calcium is often deposited at sites of cell death or in association secretions or hyalinized stroma, resulting in pathologic calcification. For example, small, irregular, linear calcifications may be seen, via

mammography Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through d ...

, in a ductal carcinoma-in-situ to produce visible radio-opacities.

Arteriosclerotic calcification

One of the principal causes of arterial stiffening with age is vascular calcification. Vascular calcification is the deposition of mineral in the form of calcium phosphate salts in the smooth muscle-rich medial layer of large

arteries An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pu ...

including the aorta.

DNA damage DNA repair is a collection of processes by which a cell identifies and corrects damage to the DNA molecules that encode its genome. In human cells, both normal metabolic activities and environmental factors such as radiation can cause DNA da ...

, especially oxidative DNA damage, causes accelerated vascular calcification.Vasclular calcification could also be linked to the chronic leakage of blood lysates into the vessel wall since red blood cells have been shown to contain a high concerntration of calcium.

Diagnosis

In terms of diagnosis, in this case vascular calcification, an ultrasound and radiography of said area is sufficient.

Treatment

Treatment of high calcium/vitamin D ratio may most easily be accomplished by intake of more

if vitamin K is normal. Intake of too much vitamin D would be evident by

anorexia Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...

, loss of appetite, or soft tissue calcification.

References

{{Electrolyte abnormalities Calcium Histopathology Biomineralization