title: Calciphylaxis in a patient with end-stage renal disease secondary to systemic lupus erythematosus associated with acral gangrene and mesenteric ischemia.
abstract: A patient with end stage renal disease secondary to systemic lupus erythematosus (SLE) ultimately required amputation of the four extremities and developed mesenteric ischemia. The patient presented with widespread medial calcification involving various small to medium sized arteries, although no noticeable secondary hyperparathyroidism was observed. We speculated that SLE associated with systemic vasculitis and uremic milieu over a number of years may represent the perfect preexisting condition for calcific arteriolopathy to occur following which several factors including chronic administration of corticosteroids, photosensitivity in lupus, and significant weight loss may have contributed to acral gangrene and mesenteric ischemia.
authors.affiliation: Department of Internal Medicine, Takasago Municipal Hospital.
authors.forename: N
authors.initials: N
authors.lastname: Igaki
authors.forename: R
authors.initials: R
authors.lastname: Moriguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Hirota
authors.forename: M
authors.initials: M
authors.lastname: Sakai
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.forename: F
authors.initials: F
authors.lastname: Tamada
authors.forename: M
authors.initials: M
authors.lastname: Oimomi
authors.forename: T
authors.initials: T
authors.lastname: Goto
mesh_terms: D000671:Amputation, Surgical; D000792:Angiography; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000150:complications* / Q000209:etiology; D002115:Calciphylaxis / Q000097:blood / Q000209:etiology* / Q000601:surgery; D002118:Calcium / Q000097:blood; D005260:Female; D005385:Fingers / Q000098:blood supply; D005734:Gangrene / Q000097:blood / Q000209:etiology / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000150:complications / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D013152:Splanchnic Circulation; D013256:Steroids; D014034:Toes / Q000098:blood supply; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D000893:Anti-Inflammatory Agents; D010281:Parathyroid Hormone; D013256:Steroids; D010758:Phosphorus; D002118:Calcium