Calciphylaxis in chronic, non-dialysis-dependent renal disease

BMC Nephrology

Harald Achenbach³  Ralf Paschke¹  Jörg Schwock²  Rainer U Pliquett³ 

[1] Internal-Medicine Department III, University of Leipzig, Phillip-Rosenthal-Str. 27, Leipzig, Germany;Department of Pathology, University of Leipzig, Liebig-Str. 26, Leipzig, Germany;Department of Nephrology, University of Leipzig, Phillip-Rosenthal-Str. 27, Leipzig, Germany

Others  :  1083449
DOI  :  10.1186/1471-2369-4-8

 received in 2003-05-26, accepted in 2003-09-29,  发布年份 2003

【 摘 要 】

Background

Calciphylaxis cutis is characterized by media calcification of arteries and, most prominently, of cutaneous and subcutaneous arterioles occurring in renal insufficiency patients.

Case Report

A 53-year-old woman with chronic cardiac and renal failure complained of painful crural, non-varicosis ulcers. She was hospitalized in an immobilized condition due to both the crural ulcerations and the existing heart-failure state (NYHA III-IV) having pleural and pericardial effusions, atrial fibrillation and weight loss of 30 kg over the past year. Despite normalization of calcium-phosphorus balance and improvement of renal function, the clinical course of crural ulcerations deteriorated during the following 3 months. After failure of surgical debridements, multiple courses of sterile-maggot therapy were introduced at a late stage to stabilize the wounds. The patient died of recurrent wound infections and sepsis paralleled by exacerbations of renal malfunction.

Conclusions

The role of renal disease in vascular complications is discussed. Sterile-maggot debridement may constitute a therapy for the ulcerated calciphylaxis at an earlier stage, i.e. when first ulcerations appear.

【 授权许可】

   
2003 Pliquett et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

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