Calciphylaxis in two patients with end-stage renal disease.
Fatal calciphylaxis (CPX) occurred in two 71-year-old females both requiring haemodialysis for end-stage renal disease. Case 2 also had an associated follicular lymphoplasmocytoid lymphoma. Although laboratory tests disclosed normal coagulation parameters, this woman had a striking cutaneous histological picture of vessel thrombosis and finally died of disseminated intravascular coagulation. CPX is a rare but potentially life-threatening complication of renal failure. The clinical picture is primarily characterized by livedoid purpura with subsequent cutaneous ischaemia and painful ulcerations. Cutaneous ischaemic phenomena are sustained by a progressive process of vascular calcification and thrombosis involving small to medium size arteries of the dermis and subcutis. Although not yet clearly explained, the pathogenetic role of a predisposing hypercoagulability state is currently the most frequently considered hypothesis.
Filosa
G
G
Department of Dermatology, A. Murri Hospital Via dei Colli, AN, Italy. dermjesi@yahoo.it
Bugatti
L
L
Nicolini
M
M
Verdolini
R
R
D000368:Aged; D001707:Biopsy, Needle; D002115:Calciphylaxis / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008134:Long-Term Care; D006435:Renal Dialysis; D012720:Severity of Illness Index