Schnur Jack, Sinawe Hadeer, Yoham Athina Lidia, Casadesus Damian
Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA.
Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA
BMJ Case Rep. 2021 Mar 24;14(3):e240310. doi: 10.1136/bcr-2020-240310.
Calciphylaxis is a rare life-threatening condition, with calcification of small and medium-sized vessels leading to skin necrosis. It has a high morbidity and mortality, and most of the patients die from wound superinfection and sepsis. A 48-year-old man with a history of end-stage renal disease on haemodialysis and Coumadin therapy for venous thromboembolism presented with pulmonary oedema after missing two haemodialysis treatment. At examination, he had bilateral lower extremity dark brown, possibly necrotic, painful ulcers. He was diagnosed with calciphylaxis and treated with sevelamer hydrochloride, low calcium dialysate and sodium thiosulfate with haemodialysis. He received daily wound care with topical collagenase. After daily wound care treatment for 4 months, the patient's ulcers completely healed. The patient had been followed for 8 months, which included 29 additional readmissions, 3 admissions related to bacteraemia and 26 admissions with the diagnosis of pulmonary oedema and hyperkalaemia requiring haemodialysis.
钙过敏是一种罕见的危及生命的疾病，中小血管钙化导致皮肤坏死。其发病率和死亡率很高，大多数患者死于伤口超级感染和败血症。一名48岁男性，有终末期肾病病史，正在接受血液透析，并因静脉血栓栓塞接受华法林治疗，在错过两次血液透析治疗后出现肺水肿。检查时，他双侧下肢有暗褐色、可能坏死的疼痛性溃疡。他被诊断为钙过敏，并接受了盐酸司维拉姆、低钙透析液和硫代硫酸钠血液透析治疗。他每天接受外用胶原酶伤口护理。经过4个月的每日伤口护理治疗，患者的溃疡完全愈合。该患者已随访8个月，期间另有29次入院，3次与菌血症有关，26次因诊断为肺水肿和高钾血症需要血液透析而入院。
