Calciphylaxis precipitated by ultraviolet light in a patient with end-stage renal disease secondary to systemic lupus erythematosus.
Calciphylaxis is a rare and severe calcification syndrome described mainly in patients with end-stage renal disease (ESRD) undergoing dialysis or with a renal transplant. This life-threatening condition is characterized by the abrupt onset of painful ischemic skin ulcers and necrosis. Secondary local and systemic infection may supervene and, without timely and appropriate interventions, calciphylaxis may be fatal. A precipitant or challenging agent is believed to be necessary to initiate the process. We describe a case of a woman with ESRD receiving continuous ambulatory peritoneal dialysis who developed calciphylaxis in the setting of severe hyperparathyroidism after receiving UV photoradiation therapy. We suggest that the UV light served as the challenging agent in the precipitation of this devastating condition.
James
L R
LR
Divisions of Nephrology, Pathology, and Surgery, Toronto General Hospital and Faculty of Medicine, University of Toronto, Toronto, Canada.
Lajoie
G
G
Prajapati
D
D
Gan
B S
BS
Bargman
J M
JM
D000328:Adult; D001158:Arteries / Q000473:pathology; D002115:Calciphylaxis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012867:Skin / Q000098:blood supply; D014467:Ultraviolet Therapy / Q000009:adverse effects*