Chinnappan Justine, Aguirre Jesus, Marcus Huda, Azher Qazi, Bachuwa Ghassan
Internal Medicine, Hurley Medical Center - Michigan State University, Flint, USA.
Pathology, Hurley Medical Center - Michigan State University, Flint, USA.
Cureus. 2023 Mar 24;15(3):e36641. doi: 10.7759/cureus.36641. eCollection 2023 Mar.
Calciphylaxis is an infrequent yet lethal disease often associated with end-stage kidney disease (ESKD). The most common sites include proximal and distal extremities and the trunk, with few reported in the penis and very few as gastrointestinal (GI) disease. We report a case of systemic calciphylaxis in a middle-aged male, presenting with a colostomy leak and parastomal abscess. Workup revealed severe calcification of the intestinal arteries and ischemic colon necrosis. The patient underwent colectomy, antibiotic therapy, regular hemodialysis (HD), and sodium thiosulphate infusion with clinical stability. Histopathology of the colon revealed ischemic necrosis and pericolonic vessel calcification suggestive of calciphylaxis. It is an important differential to be considered in patients with risk factors presenting with symptoms of gastrointestinal hemorrhage and necrosis with perforation.
钙过敏症是一种罕见但致命的疾病，常与终末期肾病（ESKD）相关。最常见的发病部位包括四肢近端和远端以及躯干，阴茎部位报道较少，而作为胃肠道（GI）疾病的则极少。我们报告一例中年男性系统性钙过敏症病例，该患者出现结肠造口漏和造口旁脓肿。检查发现肠道动脉严重钙化以及缺血性结肠坏死。患者接受了结肠切除术、抗生素治疗、定期血液透析（HD）以及硫代硫酸钠输注，病情临床稳定。结肠组织病理学检查显示缺血性坏死和结肠周围血管钙化，提示为钙过敏症。对于有危险因素且出现胃肠道出血、坏死伴穿孔症状的患者，这是一个需要考虑的重要鉴别诊断。
