title: Unusual case of calciphylaxis associated with primary hyperparathyroidism without coexistent renal failure.
abstract: OBJECTIVE
  To report a case of calciphylaxis in a patient with primary hyperparathyroidism without coexistent renal failure.
  
  
  METHODS
  The clinical, laboratory, and radiographic details of this case are reviewed, and the pathogenesis of calciphylaxis and the associated prognosis are discussed.
  
  
  RESULTS
  A 52-year-old woman had progressive fatigue, cachexia, severe osteoporosis, and necrotizing skin lesions. Her serum calcium level was 16 mg/dL, serum phosphorus level was 2.13 mg/dL, and parathyroid hormone level was 2,257 pg/mL (reference range, 15 to 65). On physical examination, gangrenous skin lesions with black crusts were noted on her legs, abdomen, and gluteal region. A mass lesion was detected in the parathyroid region by both ultrasonography and a parathyroid scan. The patient underwent a bilateral neck exploration, and a parathyroid adenoma measuring 3.5 by 1.5 by 1.2 cm was found on pathologic examination. After the operation, biochemical findings normalized, and the skin lesions progressively improved.
  
  
  CONCLUSIONS
  Severe primary hyperparathyroidism may be a factor leading to calciphylaxis, even in the absence of renal failure and a high calcium-phosphate product. This potentially life-threatening condition should not be left untreated if the levels of serum calcium and parathyroid hormone are severely elevated.
authors.affiliation: Department of Endocrinology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Akalin
authors.forename: Hatice
authors.initials: H
authors.lastname: Kilincal
authors.forename: Haluk
authors.initials: H
authors.lastname: Kiper
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002115:Calciphylaxis / Q000175:diagnosis / Q000209:etiology*; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium