Calcification is the accumulation of

calcium Calcium is a chemical element; it has 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 it ...

salts in a

body tissue In biology, tissue is an assembly of similar cells and their extracellular matrix from the same embryonic origin that together carry out a specific function. Tissues occupy a biological organizational level between cells and a complete org ...

. It normally occurs in the formation of

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

, but calcium can be deposited abnormally in

soft tissue Soft tissue connective tissue, connects and surrounds or supports internal organs and bones, and includes muscle, tendons, ligaments, Adipose tissue, fat, fibrous tissue, Lymphatic vessel, lymph and blood vessels, fasciae, and synovial membranes.� ...

,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 rock, sedimentary formation of rocks, formations (microbialite) that are created mainly by Photosynthesis, photosynthetic microorganisms such as cyanobacteria, sulfate-reducing micr ...

s or

mollusc shell The mollusc (or mollusk) shell is typically a calcareous exoskeleton which encloses, supports and protects the soft parts of an animal in the phylum Mollusca, which includes snails, clams, tusk shells, and several other classes. Not all shelled ...

s (see

Biomineralization Biomineralization, also written biomineralisation, is the process by which living organisms produce minerals, often resulting in hardened or stiffened '' mineralized tissues''. It is an extremely widespread phenomenon: all six taxonomic kingd ...

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 biological one-way valve that allows blood to flow in one direction through the chambers of the heart. A mammalian heart usually has four valves. Together, the valves determine the direction of blood flow through the heart. Hea ...

, 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 structurally related, fat-soluble compounds responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, along with numerous other biological functions. In humans, the most important compo ...

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

anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...

), 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

mucopolysaccharide Glycosaminoglycans (GAGs) or mucopolysaccharides are long, linear polysaccharide Polysaccharides (), or polycarbohydrates, are the most abundant carbohydrates found in food. They are long-chain polymeric carbohydrates composed of monosacchari ...

s. 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 consequenc ...

, 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 ...

, 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 (also known as the pineal body or epiphysis cerebri) is a small endocrine gland in the brain of most vertebrates. It produces melatonin, a serotonin-derived hormone, which modulates sleep, sleep patterns following the diurnal c ...

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 bloo ...

* Brain, e.g.

primary familial brain calcification Primary 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, Dominance_(genetics), genetically dom ...

(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 ...

usually in the

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

* Tumor calcification * Arthritic

bone spurs An exostosis, also known as a osteochondroma, is a benign chondrogenic lesions derived from aberrant cartilage from the perichondral ring. Exostoses can cause chronic pain ranging from mild to moderate, but rarely severe, depending on the shape, s ...

Kidney stones Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of cr ...

* Gall stones * Heterotopic bone *

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, foreign ...

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 (tooth), pulp organ in teeth. Pulp stones are not painful unless they impinge on nerves. They are classifi ...

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; DICOM modality: MG) 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 cance ...

, 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 () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...

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. A weakened capacity for DNA repair is a risk factor for the development of cancer. DNA is constantly modified ...

, especially oxidative DNA damage, causes accelerated vascular calcification. Vascular 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 concentration 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 vitamin D if vitamin K is normal. Intake of too much vitamin D would be evident by

anorexia Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. Individuals wit ...

, loss of appetite, or soft tissue calcification.

References

{{Electrolyte abnormalities Calcium Histopathology Biomineralization