Breast pain in a patient on dialysis: a rare manifestation of calcific uraemic arteriolopathy

• Published in: BMJ case reports Vol. 2015; p. bcr2014207946
• Main Authors: Buscher, Konrad, Gabriëls, Gert, Barth, Peter, Pavenstädt, Hermann
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 09.01.2015; BMJ Publishing Group
• Series: Case Report
• Subjects: Anticoagulants; Biopsy; Calcification; Calciphylaxis - etiology; Calciphylaxis - therapy; Combined Modality Therapy; Creatinine; Europe (West); Female; Gynecology; Hemodialysis; Humans; Interdisciplinary aspects; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Lymphatic system; Mammography; Mastodynia - etiology; Mastodynia - therapy; Middle Aged; Nephrology; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Phosphorus; Rare Disease; Ultrasonic imaging; White; Wound healing
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2014-207946

A 63-year-old woman presented with progredient bilateral breast pain. Her medical history included rheumatoid arthritis, AA amyloidosis and end-stage renal disease treated by peritoneal dialysis. Inflamed skin alterations of the breast and laboratory values suggested mastitis non-puerpuralis but antibiotics did not resolve the symptoms. Sonography and mammography showed severe vessel calcification suggesting calcific uraemic arteriolopathy (calciphylaxis) as a rare complication of chronic kidney disease. Treatment included intensified haemodialysis, thiosulfate application, analgaesia and wound management leading to significant improvement, however, without complete remission.