Severe calciphylaxis in a renal patient on long-term oral anticoagulant therapy.
The pathogenesis of calciphylaxis, a potentially life-threatening condition, is not well understood. Several factors such as end-stage renal disease (azotemia), hyperparathyroidism, hyperphosphatemia, hypercalcemia, a high calcium-phosphate product, and the use of steroids and cytotoxic drugs after kidney transplantation are believed to interact in calciphylaxis. Recently, hypercoagulability due to functional protein C deficiency has been suggested to play a pathogenic role in this condition. Here, we present a renal transplant patient, with secondary hyperparathyroidism and on long-term oral anticoagulant therapy, who developed calciphylaxis with severe skin necrosis of her legs. The patient's condition improved dramatically after total parathyroidectomy. Hypercoagulability, therefore, does not appear to have played a significant role in this case of calciphylaxis.
Rudwaleit
M
M
Department of Nephrology, Benjamin Franklin Clinic, Free University, Berlin, Germany.
Schwarz
A
A
Trautmann
C
C
Offermann
G
G
Distler
A
A
D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001780:Blood Coagulation Tests; D002115:Calciphylaxis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications*; D008875:Middle Aged; D009336:Necrosis; D012867:Skin / Q000473:pathology
D000925:Anticoagulants