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59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Calciphylaxis is a very uncommon and severe disease which mainly appears in patients with chronic renal insufficiency. It presents with ischemia and necrosis of the skin, subcutaneous adipose tissue, muscles and rarely viscera. The pathogenetic mechanisms inducing calciphylaxis are for the most part unknown. The mortality rate of 80% in the first year is very high. Patients experience marked pain, recurrent infections and the constant risk of secondary sepsis. Even multidisciplinary therapeutic strategies are limited, although there are recent case reports providing promising new therapeutic options including sodium thiosulfate and cinacalcet. This review summarizes the important aspects of diagnosis, pathogenesis, prevention and the possible therapeutic strategies of this intriguing, rare and often fatal disease.
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PMID:Calciphylaxis: no therapeutic concepts for a poorly understood syndrome? 1745 92

Calciphylaxis is a rare condition with a high mortality involving mural calcification of small vessels and occurring primarily in patients with end-stage renal disease. Most cases are characterized by rapid progression of tender subcutaneous nodules or cutaneous plaques to epidermal necrosis, with death in the majority of cases occurring from sepsis. The condition is still poorly understood and the pathogenesis not known. We report a case of calciphylaxis following an unusually benign course. Our patient was a 63-year-old Chinese woman with end-stage renal failure undergoing peritoneal dialysis who presented with itchy pruriginous rashes on her limbs and trunk with subsequent development of eschars and ulceration. Biopsy confirmed the presence of calcification within vessel walls in the subcutis. She was managed conservatively and refused a parathyroidectomy. Surprisingly, her disease did not worsen but remained stable. She died from an acute myocardial infarction 5 months after presenting to our clinic.
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PMID:Calciphylaxis with a protracted course in a patient with end-stage renal failure. 1729 9

Calciphylaxis is a cause of painful deep ulcers. There is controversy about best wound management in this disease. A retrospective study of inpatients during the 3 years was made. Seven calciphylaxis patients were identified. All patients suffered from various associated pathologies including diabetes mellitus type II and chronic renal insufficiency. Ulcers were treated by aggressive and deep shaving combined with autologous split-skin grafting in the same session. A 30% to 90% take rate of the grafts eventually with a complete ulcer healing in 6 of 7 patients was achieved. No patient developed a deep cutaneous infection or sepsis. All patients are still alive except one. The single death was related to cardiovascular complications. In distal calciphylaxis, aggressive ulcer surgery with defect closure offers a marked improvement in quality of life and prevents early deep skin infections and sepsis as major causes of mortality.
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PMID:Deep ulcer shaving combined with split-skin transplantation in distal calciphylaxis. 1849 77

A 52-year-old woman was admitted with complaints of nonhealing skin ulcers. The laboratory assessment showed a calcium level of 13.2 mg/dL (normal 8.4-10.2 mg/dL), albumin 2 g/dL (normal 3.5-4.8 g/dL), corrected calcium 14.8 mg/dL, phosphorus 1.4 mg/dL (normal 2.4-4.7 mg/dL), creatinine 0.7 mg/dL (normal 0.5-1.2 mg/dL), parathyroid hormone 893.3 pg/mL (normal 11.1-79.5 pg/mL). A technetium-sestamibi scan showed a left inferior parathyroid adenoma. The patient underwent a parathyroidectomy. Pathology showed a parathyroid adenoma. Despite treatment of her skin wounds with broad spectrum antibiotics and local wound care, the patient died of overwhelming sepsis. Calciphylaxis is a rare but serious disorder that leads to skin and soft tissue necrosis and requires prompt diagnosis and management.
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PMID:Calciphylaxis in primary hyperparathyroidism: a case report and brief review. 1920 21

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.
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PMID:Calciphylaxis in a cardiac patient without renal disease. 1931 4

Calciphylaxis is a poorly understood syndrome of vascular calcification and skin necrosis. It affects 1-4% of the population with end stage renal disease (ESRD). Disorders implicated in the pathogenesis of calciphylaxis include chronic renal failure, hypercalcemia, hyperphosphatemia, an elevated calcium-phosphate product, and secondary hyperparathyroidism (Essary, L.R. and Wick, M.R. (2000) Cutaneous calciphylaxis. An underrecognized clinicopathologic entity. Am. J. Clin. Pathol. 113, 280-287, Beitz, J.M. (2004) Calciphylaxis:an uncommon but potentially deadly form of skin necrosis. Am. J. Nurs. 104, 36-37.). Although these abnormalities are extremely common in-patients with ESRD, calciphylaxis is relatively rare. The mortality rate of calciphylaxis is about 60-80%. The leading cause of death is sepsis from necrotic skin lesions (Hitti,W.A., Papadimitriou, J.C., Bartlett, S. and Wali, R.K. (2007) Spontaneous cutaneous ulcers in a patient with a moderate degree of chronic kidney disease: a different spectrum of calciphylaxis. Scand. J. Urol. Nephrol.1-3.). Here, we report a case of calciphylaxis in a 23-year-old female with past history of chronic renal failure, renal transplantation and intake of immunosuppressive drug. The relevant literature was discussed.
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PMID:Calciphylaxis cutis: a case report and review of literature. 1934 63

Calciphylaxis is an infrequent but severe entity found in chronic dialysis patients. Its clinical pattern consists of tissue ischemia with itchy and painful subcutaneous nodules and plaques, most often located on the abdomen, buttocks, thighs and/or legs. These injuries evolve to extensive superficial necrosis of the skin overlying the panniculitis, with ulceration, overinfection and consequent sepsis. Current treatment modalities used to counteract this pathology are not entirely effective. A new treatment reported for calciphylaxis, is the use of intravenous sodium thiosulfate. This inorganic salt is already used in the treatment of intoxication caused by cyanide, in patients with calcific nephrolithiasis and tumoral calcinosis, with very good and safe results. We herewith report a case of calciphylaxis that was cured using intravenous sodium thiosulphate treatment.
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PMID:Use of sodium thiosulfate in the treatment of calciphylaxis. 1986 72

Calciphylaxis is a rare complication of chronic renal failure mostly with poor prognosis. Painful lesions on various skin surface areas are the most prominent feature of this serious disease. Subsequent infection of necrotic skin tissue is associated with the risk of sepsis. Pathophysiology is unclear, but several risk factors are known. The most important risk factor is impaired calcium-phosphate metabolism. Our paper describes two cases of different forms of calciphylaxis in patients with chronic renal failure. In the first case, pamidronate and cinacalcet were used for treatment. In the second described case, calciphylaxis was associated with secondary hyperparathyroidism and immediate subtotal parathyroidectomy was performed. Both patients were successfully treated, using systemic approach as well as dedicated local care for healing of skin wounds.
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PMID:Skin wounds associated with calciphylaxis in end-stage renal disease patients on dialysis. 2069 3

Calciphylaxis is a rare disease which has been increasingly reported in recent decades and has consequently shifted into the focus of clinical and scientific research. The clinical picture is characterized by extensive ischemic ulcerations of the skin and subcutis. Histologically, the small vessels in these lesions show prominent calcifications. Due to the extensive areas of ulceration and necrosis as well as frequently present comorbidities, patients with calciphylaxis are prone to infection and sepsis. In this work, we describe the case of a female kidney-transplant patient with vasculitis who, despite good graft function, developed a fulminant calciphylaxis of both thighs 4 years post transplantation and died of septic complications. The differential diagnoses as well as clinical procedures are described in detail in the case history. In the discussion, we give an overview of the current state of knowledge regarding the etiopathogenesis, risk factors, diagnostic measures and clinical management of calciphylaxis.
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PMID:[Calciphylaxis. A less well-known, clinically relevant disease]. 2105

Calciphylaxis is characterized by progressive vascular calcification, soft tissue necrosis, and ischemic necrosis of the skin. The condition is usually associated with end-stage renal disease and has a poor prognosis. We present a 76-year-old man on hemodialysis who developed small, painful purpura on the thigh. The purpura rapidly spread to his back and hip and became ulcerated. Histological examination of a skin biopsy revealed arterial calcification in the subcutaneous adipose tissue. We therefore diagnosed calciphylaxis and administered intravenous antibiotics and debrided the necrotic soft tissue. However, the lesions did not heal and the patient died from sepsis related to cellulitis.
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PMID:[A case of calciphylaxis in chronic renal failure]. 2106 68


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