Poch E, Almirall J, Alsina M, del Río R, Cases A, Revert L
Nephrology and Dermatology Services, Hospital Clinic i Provincial, Universitat de Barcelona, Spain.
Am J Kidney Dis. 1992 Mar;19(3):285-8. doi: 10.1016/s0272-6386(13)80011-x.
Chronic renal failure patients are prone to soft tissue calcifications. A phenomenon of acute ischemic skin necrosis and dermohypodermic arteriolar medial calcification has been described recently in patients with chronic renal failure and secondary hyperparathyroidism (HPT). This phenomenon, termed calciphylaxis, occurs in response to certain factors, the most important of which appears to be an elevated blood calcium-phosphate product. Accordingly, parathyroidectomy in addition to normalization of calcium-phosphate product has been proposed as the only effective therapeutic approach for this condition. We describe a case of chronic renal failure with severe secondary HPT in which the patient developed calciphylaxis 4 days after the appearance of a psoriatic flare. Four months before, a subtotal parathyroidectomy was performed for severe HPT and at the time the ulcerations appeared, blood calcium-phosphate product was correct. Etiological and physiopathological aspects of calciphylaxis are discussed.
慢性肾衰竭患者容易出现软组织钙化。最近在慢性肾衰竭和继发性甲状旁腺功能亢进（HPT）患者中描述了一种急性缺血性皮肤坏死和真皮及皮下小动脉中层钙化的现象。这种现象被称为钙化防御，是对某些因素的反应，其中最重要的似乎是血钙磷乘积升高。因此，除了使钙磷乘积正常化之外，甲状旁腺切除术已被提议作为治疗这种疾病的唯一有效方法。我们描述了一例患有严重继发性HPT的慢性肾衰竭病例，该患者在银屑病发作4天后出现了钙化防御。四个月前，因严重HPT进行了甲状旁腺次全切除术，在溃疡出现时，血钙磷乘积是正常的。本文讨论了钙化防御的病因和生理病理方面。
