title: Calciphylaxis: an unusual case with an unusual outcome.
abstract: Calciphylaxis is most common in patients with end-stage renal disease, and hyperparathyroidism is often present as well. But several cases in patients with normal renal and parathyroid function have been reported; this article describes one such case. The etiology and pathophysiology of calciphylaxis aren't well understood. There are many risk factors, and the reported median survival time is 2.6 months after diagnosis. The condition is characterized by isolated or multiple lesions that progress to firm, nonulcerated plaques and then to ischemic skin necrosis and ulceration. In August 2010, a female patient arrived at the hospital with multiple deep, painful necrotic wounds. Given this patient's presentation on admission, the nurses kept expecting the physicians to initiate end-of-life discussions with her and were surprised when this did not happen. After five days, the patient was diagnosed with calciphylaxis in the unusual presentation of normal renal and parathyroid function, and the team realized that her chances for survival were greater than expected. The nursing staff was crucial in developing and implementing an intensive treatment plan. The patient survived and made a full recovery.
authors.affiliation: Tina Wangen is an instructor in nursing in the Department of Nursing; Sandra Anderson is a nurse manager and Kathryn Fencl is a nurse in the Department of Nursing, Vascular/General Surgery; and Sandi Mangan is a nurse in the Department of Nursing, Surgical/Trauma ICU, all at the Mayo Clinic in Rochester, MN. Contact author: Tina Wangen, wangen.tina@mayo.edu. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
authors.forename: Tina
authors.initials: T
authors.lastname: Wangen
authors.forename: Sandra
authors.initials: S
authors.lastname: Anderson
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fencl
authors.forename: Sandi
authors.initials: S
authors.lastname: Mangan
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D002115:Calciphylaxis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D003693:Delirium / Q000175:diagnosis; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy; D010530:Peritoneal Dialysis / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local