Successful Management of Calciphylaxis in a Kidney Transplant Patient: Case Report
نویسندگان
چکیده
UNLABELLED Calciphylaxis is a rare and often fatal condition mostly associated with end-stage renal disease. The pathophysiology remains elusive and treatment options are scarce. We present a rare case of severe calciphylaxis after kidney transplantation in a patient with persistent hyperparathyroidism. CASE DESCRIPTION A 78-year-old man with a history of end-stage renal disease developed edema and ulcerations on both lower limbs 14 months after kidney transplantation while receiving an mammalian target of rapamycin inhibitor to manage polyoma virus-associated nephropathy. Skin biopsies taken from the ulcerations confirmed calciphylaxis. A multimodal treatment regimen combining medical (calcium-free phosphate binders, cinacalcet, paricalcitol, sodium thiosulfate, antibiotic treatment) and surgical treatments (debridement and autologous skin transplantation) ultimately resulted in successful wound healing. DISCUSSION We describe a case of severe calciphylaxis in a nonuremic patient after kidney transplantation. Rapid diagnosis by skin biopsy and an aggressive multimodal therapy regimen followed by long-term oral sodium thiosulfate treatment were crucial factors for a favorable outcome.
منابع مشابه
Cinacalcet for the treatment of calciphylaxis.
Calciphylaxis is characterized by cutaneous ischemia and necrosis and is associated with a very high mortality rate. It usually affects patients who are undergoing dialysis or who have received a kidney transplant. There is no optimal treatment, but parathyroidectomy has shown some benefit. We report herein a case of a patient with calciphylaxis and secondary hyperparathyroidism who was success...
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متن کاملCalciphylaxis following kidney transplantation: a case report
INTRODUCTION Calciphylaxis occurring after kidney transplantation is rare and rarely reported. It results in chronic non-healing wounds and is associated with a poor prognosis and is often fatal. We present a case of proximal lower limb calciphylaxis that occurred early after kidney transplantation. The patient had no classic associated risk factors. He had previously had a total parathyroidect...
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عنوان ژورنال:
دوره 2 شماره
صفحات -
تاریخ انتشار 2016