Cockerell C J, Dolan E T
University of Texas Southwestern Medical Center, Dallas.
J Am Acad Dermatol. 1992 Apr;26(4):559-62. doi: 10.1016/0190-9622(92)70080-y.
Calciphylaxis is a form of widespread calcification that may occur in patients with renal disease and hyperparathyroidism. The skin is often affected secondary to vascular compromise and ischemia. Patients infected with the human immunodeficiency virus (HIV) are predisposed to renal failure and thus may develop this serious complication.
The purpose of this article is to describe two cases of fatal calciphylaxis in patients with the acquired immunodeficiency syndrome and renal disease.
Two patients were examined clinically and through the performance of serologic studies and skin biopsies.
Both patients had a widespread livedo reticularis-like eruption, which rapidly progressed to cutaneous gangrene. Patient 1 had elevated serum calcium and phosphorus levels whereas patient 2 had normal values but had markedly elevated serum parathyroid hormone levels. Biopsy specimens in both cases showed vascular thrombosis and soft tissue calcification.
Widespread calcification may develop in patients with HIV infection and renal failure and, in some cases, calcium and phosphorus levels may be normal.
钙化防御是一种广泛的钙化形式，可能发生在肾病和甲状旁腺功能亢进患者中。皮肤常因血管受损和缺血而继发受累。感染人类免疫缺陷病毒（HIV）的患者易患肾衰竭，因此可能发生这种严重并发症。
本文旨在描述两例获得性免疫缺陷综合征和肾病患者发生的致命性钙化防御病例。
对两名患者进行了临床检查，并进行了血清学研究和皮肤活检。
两名患者均出现广泛的网状青斑样皮疹，并迅速发展为皮肤坏疽。患者1血清钙和磷水平升高，而患者2水平正常，但血清甲状旁腺激素水平显著升高。两例活检标本均显示血管血栓形成和软组织钙化。
HIV感染和肾衰竭患者可能发生广泛钙化，在某些情况下，钙和磷水平可能正常。
