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[钙过敏。呼吁跨学科合作]

[Calciphylaxis. A call for interdisciplinary cooperation].

作者信息

Brandenburg V M, Schmitz S, Floege J, Amann K, Ketteler M

机构信息

Medizinische Klinik I, Kardiologie, Universitätsklinikum der RWTH Aachen.

出版信息

Hautarzt. 2011 Jun;62(6):452-8. doi: 10.1007/s00105-011-2169-y.

Abstract

Calciphylaxis is a rare, often very painful and potentially life-threatening disorder at the interface between nephrology and dermatology. It is characterized by skin lesions and ulcerations following calcification and occlusion of cutaneous arterioles. Most patients have chronic kidney disease or are on dialysis. A concert of various, still incompletely understood local and systemic risk factors is necessary to cause the development of calciphylaxis. Since randomized prospective trials are missing, interdisciplinary treatment is based on pathophysiological considerations as well as evidence derived from case reports or case series. Normalization of mineral metabolism, intensifying dialysis and avoidance of coumarins, as well as administration of calcimimetics, bisphosphonates and sodium thiosulfate and hyperbaric oxygen therapy are often used. Supportive measures include analgesics, antibiotics and local wound care. We have initiated an internet-based registry for patients with calciphylaxis in order to collect data for improved patient care (with support from Amgen) (www.calciphylaxie.de).

摘要

钙过敏是一种罕见的、通常非常疼痛且可能危及生命的疾病,处于肾脏病学和皮肤病学的交叉领域。其特征是皮肤小动脉钙化和闭塞后出现皮肤病变和溃疡。大多数患者患有慢性肾脏病或正在接受透析。多种局部和全身危险因素相互作用,目前仍未完全明确,这些因素共同作用才会导致钙过敏的发生。由于缺乏随机前瞻性试验,跨学科治疗基于病理生理学考量以及来自病例报告或病例系列的证据。通常采用矿物质代谢正常化、强化透析、避免使用香豆素类药物,以及给予拟钙剂、双膦酸盐、硫代硫酸钠和高压氧治疗。支持性措施包括使用镇痛药、抗生素和局部伤口护理。我们已启动一个基于互联网的钙过敏患者登记系统,以便收集数据以改善患者护理(在安进公司的支持下)(www.calciphylaxie.de)。

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