Vatanapradith Athip, Pujari Ashwini, Morisetti Phani, Hayat Samina, Abreo Kenneth, Amin Bakhtiar M
Department of Internal Medicine, Louisiana State University Health Science Center, Shreveport, Louisiana.
Department of Nephrology, Louisiana State University Health Science Center, Shreveport, Louisiana.
Kidney Med. 2021 Jul 13;3(5):856-859. doi: 10.1016/j.xkme.2021.04.024. eCollection 2021 Sep-Oct.
Calcific uremic arteriolopathy, termed calciphylaxis, was previously considered a condition that developed mostly in patients requiring dialysis. It has now been described in kidney transplant patients, in advanced chronic kidney disease (CKD) patients not requiring dialysis, and in individuals with maintained kidney function. We describe an individual with CKD stage 3b with hypercalcemia who presented with features highly specific for calciphylaxis based on results of a skin biopsy. The condition has high morbidity and mortality, and thus prompts immediate cessation of the offending agents or treatment of the cause. The following case and literature review demonstrates a need for a detailed assessment of patients' risks and exposures and expanding the differential diagnosis to include calciphylaxis in nonuremic patients with necrotic ulcers with a plan for early imaging and possible biopsy.
钙化性尿毒症小动脉病，又称钙化防御，以前被认为主要发生在需要透析的患者中。现在它已在肾移植患者、不需要透析的晚期慢性肾脏病（CKD）患者以及肾功能维持正常的个体中被描述。我们描述了一名患有3b期CKD且伴有高钙血症的个体，根据皮肤活检结果，该个体表现出高度特异性的钙化防御特征。这种疾病具有高发病率和高死亡率，因此需要立即停用致病因素或治疗病因。以下病例及文献综述表明，有必要对患者的风险和暴露情况进行详细评估，并扩大鉴别诊断范围，将非尿毒症性坏死性溃疡患者中的钙化防御纳入其中，同时制定早期影像学检查和可能的活检计划。
