Sato Ryuta, Akimoto Tetsu, Imai Toshimi, Nakagawa Saki, Okada Mari, Miki Atsushi, Takeda Shinichi, Yamamoto Hisashi, Saito Osamu, Muto Shigeaki, Kusano Eiji, Nagata Daisuke
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
Intern Med. 2016;55(22):3315-3320. doi: 10.2169/internalmedicine.55.7180. Epub 2016 Nov 15.
Calciphylaxis is rare cutaneous manifestation associated with painful skin ulceration and necrosis. It primarily occurs in patients with end-stage chronic kidney disease. In this report, we would like to show our experience with a male patient presenting with minimal change nephrotic syndrome that was sequentially complicated by acute kidney injury and painful ulcerative cutaneous lesions due to calciphylaxis. There seemed to be several contributing factors, including a disturbance of the patient's mineral metabolism and the systemic use of glucocorticoids and warfarin. Various concerns regarding the diagnostic and therapeutic conundrums that were encountered in the present case are also discussed.
钙过敏是一种罕见的皮肤表现,伴有疼痛性皮肤溃疡和坏死。它主要发生在终末期慢性肾病患者中。在本报告中,我们想展示我们对一名男性患者的治疗经验,该患者患有微小病变型肾病综合征,随后并发急性肾损伤,并因钙过敏出现疼痛性溃疡性皮肤病变。似乎有几个促成因素,包括患者矿物质代谢紊乱以及全身使用糖皮质激素和华法林。本文还讨论了在该病例中遇到的关于诊断和治疗难题的各种问题。