University of Virginia, Charlottesville, USA.
The Ohio State University, Columbus, USA.
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211060580. doi: 10.1177/23247096211060580.
Calcific uremic arteriolopathy, commonly referred to as "calciphylaxis," is a rare life-threatening condition observed in patients with chronic kidney disease and end-stage renal disease on dialysis. This results in necrotic, ischemic, tender dermal lesions anywhere in the body, but mainly on the abdominal wall and lower extremities, where subcutaneous tissue is abundant. Histologically, it is defined by calcification in dermal capillaries, arterioles, and subcutaneous adipose tissues. It can occur in all advanced stages of chronic kidney disease as well as end-stage renal disease patients on hemodialysis or peritoneal dialysis. Our case highlights a successful case of calciphylaxis in a young female patient who underwent parathyroidectomy and intensification of peritoneal dialysis regimen along with the infusion of sodium thiosulphate injection resulting in complete resolution of the lesion in 3 months. With limited evidence of treatment options and increased frequency of this condition in a dialysis patient, our case highlights the key aspects of calciphylaxis management in a young end-stage renal disease patient who didn't need a change of dialysis modality. We also review the risk factors and current practiced management options of this condition in our article.
钙化尿毒症性小动脉病，通常称为“钙化防御”，是一种罕见的危及生命的疾病，发生于慢性肾脏病和透析的终末期肾病患者。这会导致全身任何部位（主要是腹壁和下肢）出现坏死性、缺血性、触痛性皮肤病变，这些部位的皮下组织丰富。组织学上，它的特征是真皮毛细血管、小动脉和皮下脂肪组织中的钙化。它可发生于慢性肾脏病的所有晚期阶段以及接受血液透析或腹膜透析的终末期肾病患者。我们的病例重点介绍了一位年轻女性患者成功治愈钙化防御的情况，该患者接受了甲状旁腺切除术，并强化了腹膜透析方案，同时输注硫代硫酸钠注射液，3 个月后完全消退。鉴于治疗选择的证据有限，且透析患者中这种疾病的频率增加，我们的病例重点介绍了在无需改变透析方式的情况下，对年轻终末期肾病患者进行钙化防御管理的关键方面。我们还在文章中回顾了这种疾病的风险因素和当前的治疗选择。
