title: Multiple sites of calciphylaxis in a patient with chronic renal failure.
abstract: Calciphylaxis has seldom been reported in patients with acute renal failure or in pre-dialysis patients. It also has been reported at lower calcium phosphorous products and in patients with adynamic bone disease. We report a pre-hemodialysis (HD) patient with acute renal failure and biopsy-proven calciphylaxis involving multiple cutaneous sites with calcification of the perineal area resulting in dry gangrene of the penis that necessitated a partial penectomy. The patient had elevated serum calcium, phosphorous and parathyroid hormone level of 612 pg/mL. The same patient suffered subsequently from a calcium embolus that occluded his left ophthalmic artery and resulted in left eye blindness. Calciphylaxis is a devastating phenomenon and physicians should have a high clinical suspicion for it in HD patients as well as in patients with late stages of chronic kidney disease.
authors.affiliation: Department of Medicine, Olive-View UCLA Medical Center; Division of Nephrology, David Geffen School of Medicine, Ronald Regan UCLA Medical Center, Los Angeles, CA, USA.
authors.forename: Ramy Magdy
authors.initials: RM
authors.lastname: Hanna
authors.forename: Joseph Riad
authors.initials: JR
authors.lastname: Nabil
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Lopez
authors.forename: Dalila B
authors.initials: DB
authors.lastname: Corry
authors.forename: James
authors.initials: J
authors.lastname: Wilson
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001706:Biopsy; D001766:Blindness / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002115:Calciphylaxis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004617:Embolism / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery; D010409:Penile Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male
chemical_list: D015415:Biomarkers