Fine A, Fleming S, Leslie W
Department of Medicine, University of Manitoba, St Boniface General Hospital, Winnipeg, Canada.
Am J Kidney Dis. 1995 Mar;25(3):498-502. doi: 10.1016/0272-6386(95)90116-7.
Calciphylaxis is a rare disease associated with hemodialysis or transplantation, high parathyroid hormone values, and increased serum calcium x phosphate (Ca x P) product. Only four patients on continuous ambulatory peritoneal dialysis have been reported with this condition. We report five cases presenting within a 2-year period with severe calf pain and tenderness with extensive nonulcerating large, hard, and tender subcutaneous plaques in the calves. Calcium deposition was confirmed radiologically and by bone scanning. Four patients were on continuous ambulatory peritoneal dialysis, and the other was not yet on dialysis. High serum Ca x P product was found in three of these patients at onset of the condition. Two patients had normal parathyroid hormone levels at onset. Calcium salts and/or calcitriol had been taken prior to onset in three patients. When presenting in this fashion, the diagnosis can be easily made by the uniqueness of the physical findings in the legs. Our observation suggests that the condition should no longer be considered rare and is not confined to hemodialysis patients. Furthermore, it can occur in predialysis patients.
钙过敏是一种与血液透析或移植、甲状旁腺激素值升高以及血清钙磷（Ca×P）乘积增加相关的罕见疾病。据报道，仅有4例持续性非卧床腹膜透析患者患有此病。我们报告了5例在2年期间出现的病例，这些患者小腿严重疼痛且压痛，小腿有广泛的非溃疡性、大的、坚硬且压痛的皮下斑块。通过放射学检查和骨扫描证实了钙沉积。其中4例患者进行持续性非卧床腹膜透析，另1例尚未进行透析。在这些患者中，有3例在发病初期血清Ca×P乘积较高。2例患者发病初期甲状旁腺激素水平正常。3例患者在发病前服用过钙盐和/或骨化三醇。当以这种方式表现时，通过腿部独特的体格检查结果很容易做出诊断。我们的观察表明，这种疾病不应再被视为罕见疾病，且不仅限于血液透析患者。此外，它也可发生在透析前患者中。
