Calciphylaxis in a cardiac patient without renal disease.

Abstract

Calciphylaxis is a rare complication that occurs in 1% of patients with end-stage renal disease (ESRD) each year. Extensive microvascular calcification and occlusion/thrombosis lead to violaceous skin lesions, which progress to nonhealing ulcers with secondary infection, often leading to sepsis and death. The lower extremities are predominantly involved (roughly 90% of patients). Although most calciphylaxis patients have abnormalities of the calcium-phosphate axis or elevated levels of parathyroid hormone, these abnormalities do not appear to be fundamental to the pathophysiology of the disorder. We report on a case of histologically proven calciphylaxis in a 54-year-old woman with normal renal function and normal calcium-parathyroid homeostasis. She had a history of alcoholic cardiomyopathy, and was treated with warfarin anticoagulation. She has been successfully treated with antibiotics, i.v. biophosphonates and intensive local wound care. We recorded a complete wound healing in contrast to what is reported in other series.

• Authors: Amar Almafragi, Jo Vandorpe, Karl Dujardin
• Journal: Acta cardiologica (Acta Cardiol) Vol. 64 Issue 1 Pg. 91-3 (Feb 2009) ISSN: 0001-5385 [Print] England
• PMID: 19317304 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Anticoagulants
• Diphosphonates
• Thienamycins
• Clindamycin
• Warfarin
• Vancomycin
• Meropenem

Topics

• Alcoholism (complications)
• Anti-Bacterial Agents (therapeutic use)
• Anticoagulants (adverse effects)
• Calciphylaxis (chemically induced, drug therapy, etiology, physiopathology)
• Clindamycin (therapeutic use)
• Diphosphonates (therapeutic use)
• Female
• Heart Diseases (complications, etiology, physiopathology)
• Humans
• Kidney Failure, Chronic (physiopathology)
• Meropenem
• Middle Aged
• Risk Factors
• Thienamycins (therapeutic use)
• Vancomycin (therapeutic use)
• Warfarin (adverse effects)