Breast pain in a patient on dialysis: a rare manifestation of calcific uraemic arteriolopathy

Buscher, Konrad; Gabriëls, Gert; Barth, Peter S.; Pavenstädt, Hermann

doi:10.1136/bcr-2014-207946

Cited by 7 publications

(1 citation statement)

References 9 publications

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“…Few cases of calciphylaxis in such patients involving the breast parenchyma have been reported previously. 3 4 These tend to mimic malignancy when they present with large ulcers and biopsy is necessary to avoid undue surgeries. Uncommonly such calcification can occur due to nonrenal causes like hyperparathyroidism, liver disease, underlying malignancy, and diabetes mellitus, and is called nonuremic calciphylaxis.…”

Section: Discussionmentioning

confidence: 99%

Calciphylaxis and Ulcerative Lesions of Bilateral Nipple–Areolar Complex Due to Alcoholic Liver Disease

Jha

Shrivastav

Kasyap

2022

Indian J Radiol Imaging

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When faced with eczematous lesions involving the nipple–areolar complex (NAC), Paget's disease is assumed to be the diagnosis, anything else being considered a “Zebra” necessitating its exclusion on pathology. A middle-aged lady presented with synchronous asymmetrical ulceration of bilateral NAC with pleomorphic calcifications on mammography and simultaneous extensive vascular calcification in bilateral breasts that suggested systemic cause. Calciphylaxis is a rare diagnosis occurring usually due to underlying end-stage renal disease or hyperparathyroidism. There are very few case reports of calciphylaxis due to alcoholic liver disease and no cases to the best of our knowledge involving NAC. We report an extremely rare case of breast and NAC calciphylaxis due to alcoholic liver disease, highlighting need to consider benign etiology when bilateral involvement is present.

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Section: Discussionmentioning

confidence: 99%

Calciphylaxis and Ulcerative Lesions of Bilateral Nipple–Areolar Complex Due to Alcoholic Liver Disease

Jha

Shrivastav

Kasyap

2022

Indian J Radiol Imaging

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Calciphylaxis of the breast with associated diffuse dermal angiomatosis

Maung

Hugh

2017

Human Pathology: Case Reports

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Treatment of Calciphylaxis in CKD: A Systematic Review and Meta-analysis

Udomkarnjananun

Kongnatthasate

Praditpornsilpa

et al. 2019

Kidney International Reports

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BackgroundCalciphylaxis is a life-threatening complication of chronic kidney disease (CKD). To inform clinical practice, we performed a systematic review of case reports, case series, and cohort studies to synthesize the available treatment modalities and outcomes of calciphylaxis in patients with CKD.MethodsElectronic databases were searched for studies that examined the uses of sodium thiosulfate, surgical parathyroidectomy, calcimimetics, hyperbaric oxygen therapy, and bisphosphonates for calciphylaxis in patients with CKD, including end-stage renal disease. For cohort studies, the results were synthesized quantitatively by performing random-effects model meta-analyses.ResultsA total of 147 articles met the inclusion criteria and were included in the systematic review. There were 90 case reports (90 patients), 20 case series (423 patients), and 37 cohort studies (343 patients). In the pooled cohorts, case series, and case reports, 50.3% of patients received sodium thiosulfate, 28.7% underwent surgical parathyroidectomy, 25.3% received cinacalcet, 15.3% underwent hyperbaric oxygen therapy, and 5.9% received bisphosphonates. For the subset of cohort studies, by meta-analysis, the pooled risk ratio for mortality was not significantly different among patients who received sodium thiosulfate (pooled risk ratio [RR] 0.89; 95% confidence interval [CI] 0.71–1.12), cinacalcet (pooled RR 1.04; 95% CI 0.75–1.42), hyperbaric oxygen therapy (pooled RR 0.89; 95% CI 0.71–1.12), and bisphosphonates (pooled RR 0.77; 95% CI 0.44–1.32), and those who underwent surgical parathyroidectomy (pooled RR 0.88; 95% CI 0.69–1.13).ConclusionThis systematic review found no significant clinical benefit of the 5 most frequently used treatment modalities for calciphylaxis in patients with CKD. Randomized controlled trials are needed to test the efficacy of these therapies.

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Breast pain in a patient on dialysis: a rare manifestation of calcific uraemic arteriolopathy

Cited by 7 publications

References 9 publications

Calciphylaxis and Ulcerative Lesions of Bilateral Nipple–Areolar Complex Due to Alcoholic Liver Disease

Calciphylaxis and Ulcerative Lesions of Bilateral Nipple–Areolar Complex Due to Alcoholic Liver Disease

Calciphylaxis of the breast with associated diffuse dermal angiomatosis

Treatment of Calciphylaxis in CKD: A Systematic Review and Meta-analysis

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