Calciphylaxis, A Poorly Understood Clinical Syndrome: Three Case Reports and a Review of the Literature

• Published in: Annals of vascular surgery Vol. 15; no. 4; pp. 470 - 473
• Main Authors: Howe, S.C., Murray, J.D., Reeves, R.T., Hemp, J.R., Carlisle, J.H.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.07.2001; Elsevier Limited
• Subjects: Aged; Calciphylaxis - diagnosis; Calciphylaxis - etiology; Diagnosis, Differential; Female; Humans; Hyperparathyroidism, Secondary - complications; Kidney Failure, Chronic - complications; Leg Ulcer - diagnosis; Leg Ulcer - etiology; Male; Middle Aged; Syndrome; Vascular Diseases - diagnosis; Vascular Diseases - etiology
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1007/s100160010122

Systemic calcification syndromes are a recognized complication occurring in some patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism. These patients develop severe livedo reticularis and subcutaneous tissue lesions progressing to frank necrosis and ultimately large areas of eschar. Clinically this syndrome is known as calciphylaxis; these lesions are usually resistant to aggressive debridement, systemic antibiotics, and revascularization procedures. We report three patients with somewhat different clinical presentations but all sharing a common link of exquisitely painful leg ulcers initially being treated as ischemic lesions or venous stasis-type ulcerations. These three patients were diagnosed with calciphylaxis on the basis of clinical, biochemical, and histopathological criteria. Two patients underwent parathyroidectomy late in the progression of their disease, with some resolution of their ulcerative lesions.