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Calciphylaxis following kidney transplantation: a case report.

作者信息

Hanvesakul Rajesh, Silva Michael A, Hejmadi Rahul, Mellor Steve, Ready Andrew R, Cockwell Paul, Inston Nicholas

机构信息

Department of Nephrology, University Hospital Birmingham, Birmingham B15 2TH, UK.

出版信息

J Med Case Rep. 2009 Nov 24;3:9297. doi: 10.1186/1752-1947-3-9297.

DOI:10.1186/1752-1947-3-9297
PMID:20062786
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2803820/
Abstract

INTRODUCTION

Calciphylaxis occurring after kidney transplantation is rare and rarely reported. It results in chronic non-healing wounds and is associated with a poor prognosis and is often fatal. We present a case of proximal lower limb calciphylaxis that occurred early after kidney transplantation. The patient had no classic associated risk factors. He had previously had a total parathyroidectomy but had normal serum calcium-phosphate product and parathyroid hormone levels. The clinical outcome of this case was favorable and highlights some fundamental issues relating to management.

CASE PRESENTATION

A 70-year-old British Caucasian man with end-stage renal failure secondary to IgA nephropathy presented six months post kidney transplantation with cutaneous calciphylaxis lesions involving the medial aspect of the thigh bilaterally.

CONCLUSION

To the best of our knowledge, this is the first reported case of rapid onset cutaneous calciphylaxis occurring soon after kidney transplantation that was associated with a favorable outcome. Cutaneous calciphylaxis lesions should be promptly managed with meticulous wound care, antimicrobial therapy and the correction of calcium-phosphate product where indicated.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b526/2803820/7f0b728d56e8/1752-1947-3-9297-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b526/2803820/8397344a4f2b/1752-1947-3-9297-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b526/2803820/7f0b728d56e8/1752-1947-3-9297-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b526/2803820/8397344a4f2b/1752-1947-3-9297-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b526/2803820/7f0b728d56e8/1752-1947-3-9297-2.jpg

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本文引用的文献

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Calciphylaxis from nonuremic causes: a systematic review.非尿毒症病因所致的钙过敏症:一项系统综述
Clin J Am Soc Nephrol. 2008 Jul;3(4):1139-43. doi: 10.2215/CJN.00530108. Epub 2008 Apr 16.
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Calciphylaxis: calcific uremic arteriolopathy and the emerging role of sodium thiosulfate.钙过敏症:钙化性尿毒症小动脉病及硫代硫酸钠的新作用
Int Urol Nephrol. 2008;40(2):443-51. doi: 10.1007/s11255-008-9373-4.
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Proximal calciphylaxis treated with calcimimetic 'Cinacalcet'.用拟钙剂“西那卡塞”治疗近端钙化防御。
Nephrol Dial Transplant. 2008 Jan;23(1):387-9. doi: 10.1093/ndt/gfm676. Epub 2007 Oct 2.
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Gastric calciphylaxis in a patient with a functioning renal allograft.
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Calcific uremic arteriolopathy in a transplanted kidney.移植肾中的钙化性尿毒症小动脉病
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