Calciphylaxis

Guldbakke, Kjetil Kristoffer; Khachemoune, Amor

doi:10.1111/j.1365-4632.2007.03160.x

Cited by 43 publications

(38 citation statements)

References 84 publications

(84 reference statements)

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“…It has also occurred, however, without end-stage renal disease in such disorders as cancer, autoimmune hepatitis, inflammatory bowel disease, rheumatoid arthritis, sarcoidosis, SLE, alcoholic liver disease, and primary hyperparathyroidism. 117,118 In one series of 64 patients, for example, 23% were not undergoing dialysis, although most had some degree of renal insufficiency. 118 Risk factors include obesity, liver disease, systemic corticosteroid use, and a calciumphosphate product of greater than 70 mg 2 /dL 2 .…”

Section: Other Vascular Obstruction Calcific Vasculopathy (''Calciphymentioning

confidence: 98%

“…Cutaneous lesions usually occur on either or both: (1) the distal extremities (below the elbow or, much more commonly, the knee) and (2) the proximal extremities, trunk, and buttocks. 117,118 The skin abnormalities on the distal lower extremities may begin as livedo reticularis or acral cyanosis, including blue toes, 120 but typically progress rapidly to ulceration and gangrene. In the proximal form, the cutaneous lesions tend to overlie thick adipose tissues of the abdomen, thigh, and buttocks and begin as erythema J AM ACAD DERMATOL VOLUME 60, NUMBER 1 that evolves into violaceous, indurated nodules or plaques.…”

Section: Other Vascular Obstruction Calcific Vasculopathy (''Calciphymentioning

confidence: 99%

“…It is most common in patients with end-stage renal disease, including kidney transplant recipients and those undergoing chronic peritoneal or hemodialysis. [117][118][119] They often have evidence of secondary or tertiary hyperparathyroidism with an elevated serum calcium-phosphate product. It has also occurred, however, without end-stage renal disease in such disorders as cancer, autoimmune hepatitis, inflammatory bowel disease, rheumatoid arthritis, sarcoidosis, SLE, alcoholic liver disease, and primary hyperparathyroidism.…”

Section: Other Vascular Obstruction Calcific Vasculopathy (''Calciphymentioning

confidence: 99%

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Blue (or purple) toe syndrome

Hirschmann¹,

Raugi²

2009

Journal of the American Academy of Dermatology

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Section: Other Vascular Obstruction Calcific Vasculopathy (''Calciphymentioning

confidence: 98%

Section: Other Vascular Obstruction Calcific Vasculopathy (''Calciphymentioning

confidence: 99%

Section: Other Vascular Obstruction Calcific Vasculopathy (''Calciphymentioning

confidence: 99%

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Blue (or purple) toe syndrome

Hirschmann¹,

Raugi²

2009

Journal of the American Academy of Dermatology

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“…These findings support a more complicated and multifaceted pathogenesis than that originally described by Selye et al This view is further supported by the sheer volume of risk factors for the development of calciphylaxis reported in traditional cases-and frequently contradicted-in the literature. [5][6][7][8][9]18 This is likely due to the relative rarity of calciphylaxis,limitinganalysestosmallcaseseriesandreviews. 18 A few larger case-control studies have identified several consistent statistically associated risk factors for the development of calciphylaxis in traditional patients.…”

Section: Commentmentioning

confidence: 99%

Calciphylaxis With Normal Renal and Parathyroid Function

Kalajian¹,

Malhotra²,

Callen³

et al. 2009

Arch Dermatol

105

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Background: Calciphylaxis is a life-threatening form of metastatic calcification-induced microvascular occlusion syndrome. Although traditionally observed in patients with end-stage renal disease and/or hyperparathyroidism, the development of calciphylaxis in "nontraditional" patients having both normal renal and parathyroid function has been reported. However, to date there has been no collective analysis identifying common patient characteristics potentially predisposing to the development of calciphylaxis in nontraditional patients.Observations: A 58-year-old woman with endometrial carcinoma developed extensive calciphylaxis despite the presence of normal renal and parathyroid function. The disease resolved with rapid diagnosis, supportive therapy, and medical management. Analysis of this case and the 13 previously reported cases of nontraditional calciphylaxis identified the following patient characteristics that highlight clinical situations potentially predisposing to calciphylaxis: hypoalbuminemia, malignant neoplasm, systemic corticosteroid use, anticoagulation with warfarin sodium or phenprocoumon, chemotherapy, systemic inflammation, hepatic cirrhosis, protein C or S deficiency, obesity, rapid weight loss, and infection.Conclusions: Calciphylaxis is becoming increasingly common in patients with normal renal and parathyroid function. The observations from this study may assist dermatologists in the rapid diagnosis and prompt initiation of therapy for this devastating disease.

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“…Consideration of predisposing conditions, risk factors and alertness to ‘warning signals' (extreme pain, livid cutaneous nodules and indurations, livedo sign, typical bizzare configuration of skin ischemia and necrosis) are generally sufficient to characterize the disease [15]. Skin biopsy, although desirable, frequently has been avoided, since progressive skin necrosis may be precipitated at the biopsy site.…”

Section: Introductionmentioning

confidence: 99%

Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data

Salmhofer

Franzen

Hitzl

et al. 2013

Kidney Blood Press Res

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Background: Calciphylaxis is a rare, yet life-threatening disease mainly occurring in dialysis patients. Traditional options of treatment remain unsatisfactory. Methods: Here we present a novel, combined approach, treating calciphylaxis with IV sodium thiosulfate, cinacalcet and sevelamer. In a case series five hemodialysis patients, have been successfully treated with this regimen. Treatment and survival data were analyzed using descriptive statistics. Results: In all patients, a rapid decrease in pain, improvement of general condition and wound healing within six months occurred. Side effects were low. Drug dosages: IV sodium thiosulfate initial dose 119.4 +/- 84.9 g/m²/week, maintenance dose 40.6 +/- 9 g/m²/week; cinacalcet: maintenance dose 36 +/- 32.9 mg/d and sevelamer maintenance dose 3320 +/-1671 mg/d. One and two year survivals were 100 % and 80 %, respectively. We also report on long-term application of IV sodium thiosulfate of up to 52 months. Patient survival after diagnosis was 52, 84, 21, 36 and 30 months, respectively. Survival since initiation of hemodialysis was 76, 136, 89, 36 and 35 months, respectively. Conclusion: This novel combined approach, a multi-modal treatment of calciphylaxis with persistent hyperparathyroidism, using IV sodium thiosulfate, cinacalcet and sevelamer seems to improve the outcome of this devastating disease.

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Calciphylaxis

Cited by 43 publications

References 84 publications

Blue (or purple) toe syndrome

Blue (or purple) toe syndrome

Calciphylaxis With Normal Renal and Parathyroid Function

Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data

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