Alves Cyrielle, Ernandez Thomas, Stoermann Chopard Catherine
Service de néphrologie, Département des spécialités de médecine, HUG, 1211 Genève 14.
Rev Med Suisse. 2018 Feb 21;14(595):426-429.
Calciphylaxis is a rare disease with a poor prognostic that mostly occurs in patients with renal failure. Diagnosis is difficult and skin biopsy is the gold standard diagnostic procedure, although it may aggravate skin lesions. Identification of the typical cutaneous signs is important to initiate adequate medical care. Several differential diagnoses must be excluded. Treatments should include appropriate pain management, local wound pain, daily dialysis, intravenous sodium thiosulfate treatment, hyperbaric oxygenotherapy, thigh control of calcium-phosphate metabolism and interruption of medications that could contribute to calciphylaxis. Palliative care should be considered in uncontrolled clinical course.
钙过敏症是一种预后较差的罕见疾病,主要发生在肾衰竭患者中。诊断困难,皮肤活检是金标准诊断方法,尽管它可能会加重皮肤损伤。识别典型的皮肤体征对于启动适当的医疗护理很重要。必须排除几种鉴别诊断。治疗应包括适当的疼痛管理、局部伤口处理、每日透析、静脉注射硫代硫酸钠治疗、高压氧治疗、严格控制钙磷代谢以及停用可能导致钙过敏症的药物。对于病情无法控制的患者,应考虑姑息治疗。