Burdorf Benjamin T
Northeast Ohio Medical University, Rootstown, OH 44272 USA.
Radiol Case Rep. 2020 Dec 17;16(3):415-418. doi: 10.1016/j.radcr.2020.11.033. eCollection 2021 Mar.
Calciphylaxis is a deadly disease that is currently diagnosed through a skin biopsy of resultant necrotic lesions despite many cases lacking this characteristic finding. Recently, research has demonstrated the ability of various radiologic techniques to detect calciphylaxis and have promoted their capabilities in earlier diagnosis without tissue invasion. In this case, an obese 55-year-old female with end stage renal disease, and a long history of dialysis, complained of weeks of persistent abdominal pain that was accompanied by a mottled, lacey, net-like rash that resembled livedo reticularis. Computed tomography of the abdomen revealed extensive arterial calcification and subcutaneous calcium deposition. These radiologic findings, coupled to a high clinical suspicion, prompted treatment for suspected calciphylaxis. Remarkably, after 1 week the patient reported substantial improvement. Hopefully, this publication in conjunction with previous and future research will raise awareness on the role Radiologists can play in expediting the diagnostic process for a lethal disease, especially when a tissue biopsy is not a feasible option.
钙化防御是一种致命疾病,目前通过对由此产生的坏死病变进行皮肤活检来诊断,尽管许多病例缺乏这一特征性表现。最近,研究表明各种放射学技术有能力检测钙化防御,并提升了它们在不进行组织侵入的情况下进行早期诊断的能力。在这个病例中,一名55岁的肥胖女性,患有终末期肾病且有长期透析史,主诉持续数周的腹痛,并伴有类似网状青斑的斑驳、花边状、网状皮疹。腹部计算机断层扫描显示广泛的动脉钙化和皮下钙沉积。这些放射学表现,再加上高度的临床怀疑,促使对疑似钙化防御进行治疗。值得注意的是,1周后患者报告有显著改善。希望这篇发表的文章以及之前和未来的研究将提高人们对放射科医生在加速一种致命疾病诊断过程中所起作用的认识,特别是在组织活检不可行的情况下。