Injuries in minor hockey.

The authors have presented an excellent picture of a patient with calciphylaxis, who despite treatment subsequently died. The authors also comment on possible modalities of treatment, however fail to mention parathyroidectomy, which is an important treatment for patients with calciphylaxix. This disease is caused by overactivity of enlarged parathyroid glands, secondary to the failure of the kidneys to convert inactive vitamin D to active, and the resultant decreased absorption of calcium from the gut. A complete parathyroidectomy, would give a patient at least some chance to control and, possibly reverse, the affects of calciphylaxis. Although parathyroidectomy might not have saved this patient’s life, it does make a difference in many patients with calciphylaxis and should be considered as the first treatment. This severe, and usually late-developing complication may be prevented in patients with secondary hyperparathyroidism from chronic renal disease who undergo early parathyroidectomy.