Salmhofer W, Pierer G, Auer-Grumbach P, Soyer H P, Kerl H
Universitätsklinik für Dermatologie und Venerologie, Universitätsklinik für Chirurgie.
Hautarzt. 1995 Oct;46(10):726-31. doi: 10.1007/s001050050330.
A case of a 53-year-old chronically uraemic female patient who suddenly developed widespread cutaneous necrosis on both thighs is presented. On the basis of the typical histopathological features a diagnosis of calciphylaxis was made and supported by elevated serum parathyroid hormone levels. Calciphylaxis is a rare and serious disease, mostly seen in uraemic patients subjected to chronic haemodialysis. Typical features are calcifying panniculitis and thrombosis of small to medium-sized blood vessels followed by necrosis of the skin. The poor prognosis is due to systemic calcifications of visceral organs. When acute cutaneous necrosis of the skin is encountered in patients with chronic uraemia calciphylaxis should always be considered as a possible cause in the differential diagnosis. Determination of the serum parathyroid hormone level is recommended.
本文报告一例53岁慢性尿毒症女性患者，其双大腿突然出现广泛皮肤坏死。根据典型的组织病理学特征诊断为钙过敏，并得到血清甲状旁腺激素水平升高的支持。钙过敏是一种罕见且严重的疾病，多见于接受慢性血液透析的尿毒症患者。典型特征为钙化性脂膜炎和中小血管血栓形成，随后皮肤坏死。预后不良是由于内脏器官的系统性钙化。当慢性尿毒症患者出现急性皮肤坏死时，在鉴别诊断中应始终考虑钙过敏这一可能病因。建议测定血清甲状旁腺激素水平。
