Diagnosing Calciphylaxis: A Review With Emphasis on Histopathology

Bahrani, Eman; Perkins, Ifeoma U.; North, Jeffrey P.

doi:10.1097/dad.0000000000001526

Cited by 18 publications

(25 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, at present, not all the parameters found have been unanimously confirmed. In our series, the finding of more than one vessel per field involved with subintimal concentric calcifications in small cutaneous lesions supports the diagnosis of CPX, unlike the presence of thrombosis or extravascular calcification in other reports in the literature 24,29–32 …”

Section: Discussionsupporting

confidence: 84%

See 1 more Smart Citation

Cutaneous vascular calcification. Perieccrine calcification as a diagnostic key for calciphylaxis

et al. 2022

View full text Add to dashboard Cite

Background: Attempts have been made to establish discriminative criteria between classic calciphylaxis (CPX) and those cases in which cutaneous vascular calcification (CVC) represents an incidental finding (epiphenomenon).Methods: Retrospective, observational cohort study of patients with CVC to distinguish clinicopathological features between CVC as classic CPX (CVC in cutaneous lesions with erythematous-violaceous plaques with or without ulceration) or as an epiphenomenon (CVC in cutaneous lesions with known diagnosis). Different clinicopathological parameters and the presence of perieccrine calcification and pseudoxanthoma elasticum (PXE)-like changes were evaluated.Results: Sixty-six patients were studied. The CPX group showed a significantly higher percentage of renal failure, hypertension, altered laboratory parameters, painful lesions, and mortality rate. Histopathologically, the CPX group was associated with more than one vessel per field involved with subintimal concentric calcification and perieccrine calcification (observed exclusively in the CPX group), while PXE-like changes, although more frequent in the CPX group, were also observed in the epiphenomenon group. Conclusion:Perieccrine calcification and the presence of more than one vessel per field involved by concentric pattern calcification could be used as a diagnostic marker of CPX. Although PXE-like changes are not an exclusive marker, they could suggest CPX diagnosis.

show abstract

Section: Discussionsupporting

confidence: 84%

“…Several recent articles tried to identify histopathological parameters useful for CPX diagnosis 24,29–33 . Nevertheless, at present, not all the parameters found have been unanimously confirmed.…”

Section: Discussionmentioning

confidence: 95%

Cutaneous vascular calcification. Perieccrine calcification as a diagnostic key for calciphylaxis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is a destructive vascular disease that mostly occurs in patients with end-stage renal disease (ESRD). Main pathological features are calcification of the subcutaneous adipose tissue and dermal small blood vessel media, along with intimal fibrosis and thrombosis, which lead to tissue ischemic necrosis (1,2). The clinical manifestations of calciphylaxis are persistent painful skin ulcers and erosions in multiple parts of the body, accompanied by black eschar formation (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Characteristics of Calciphylaxis in Chinese Hemodialysis Patients

Liu

Yang

et al. 2022

Front. Med.

View full text Add to dashboard Cite

BackgroundCalciphylaxis is a grievous life-threatening vascular disease that commonly affects dialysis population. This is the first epidemiological survey of calciphylaxis initiated in China.MethodsIn the cross-sectional survey, a stratified sampling method was used to select 24 dialysis centers in Jiangsu Province. The participants were all adult patients in each center who had been on hemodialysis for more than 6 months. Calciphylaxis patients were uniformly diagnosed based on characteristic skin lesions and histopathological features.ResultsA total of 3,867 hemodialysis patients (average age of 55.33 ± 13.89 years; 61.81% of males) were included. Forty eight cases were diagnosed with calciphylaxis, and prevalence was 1.24%. Among calciphylaxis patients, 33 cases were male, and the average age and median dialysis duration were 53.85 ± 15.17 years and 84.00 (48.00, 138.75) months, respectively. Skin biopsy was performed in 70.83% of calciphylaxis patients, and positive rate was 64.71%. Meanwhile, the positive rate of bone scintigraphy in the diagnosis of calciphylaxis was 62.5%. The prevalence of hyperparathyroidism in case group was as high as 72.92% with longer duration, and 42.86% had undergone parathyroidectomy. Multivariate analysis indicated that increased BMI, prolonged dialysis duration, warfarin therapy, hyperparathyroidism, diabetes, tumors, low serum albumin and high serum alkaline phosphatase levels were high-risk factors for calciphylaxis.ConclusionsThe prevalence of calciphylaxis in Chinese hemodialysis patients was 1.24% according to regional epidemiological survey, but its actual prevalence would be presumably far beyond present data. It's urgent to improve clinical understanding of calciphylaxis, and multifaceted diagnostic methods should be applied for early screening.

show abstract

“…Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is a serious life-threatening vascular disease characterized by systemic arteriolar medial calcification with intimal fibrosis and thrombosis [1,2]. These pathological changes cause tissue ischemic necrosis, which further leads to skin ulcers and necrosis of surrounding tissues, even gangrene in severe cases [1,3,4].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

et al. 2021

View full text Add to dashboard Cite

Introduction: Calciphylaxis is a rare but potentially fatal disease commonly occurred in dialysis patients. Despite some previous studies on risk factors for calciphylaxis, there is still a lack of data from Chinese population. Methods: The retrospective matched case-control study about calciphylaxis was performed in Zhongda Hospital affiliated to Southeast University. The case group involved 20 hemodialysis patients who were newly diagnosed with calciphylaxis from October 2017 to December 2018. The 40 noncalciphylaxis patients undergoing dialysis with the same age and duration of dialysis were randomly selected as controls. Results: Most of calciphylaxis patients were male and elderly, while overweight people were more susceptible to the disease. Although incidence of secondary hyperparathyroidism was higher in calciphylaxis patients, the differences in duration of elevated serum intact parathyroid hormone (iPTH) and its highest value did not reach statistical significance compared with controls. No significant difference in warfarin therapy was discernible between two groups. The univariate regression analysis indicated that male, score of use of activated vitamin D and its analogues, corrected serum calcium level, serum phosphate, Ca Â P product, iPTH, albumin, and alkaline phosphatase (ALP) level were significantly associated with calciphylaxis. Elevated levels of serum phosphate (OR 4.584, p ¼ 0.027) and ALP (OR 1.179, p ¼ 0.036), decreased level of serum albumin (OR 1.330, p ¼ 0.013) were independent risk factors after multivariate analysis. Conclusion: This is the first report of risk factors associated with calciphylaxis in China. Increased levels of serum phosphate and ALP, decreased level of serum albumin were vital high-risk factors for calciphylaxis in Chinese hemodialysis population.

show abstract

Diagnosing Calciphylaxis: A Review With Emphasis on Histopathology

Cited by 18 publications

References 40 publications

Cutaneous vascular calcification. Perieccrine calcification as a diagnostic key for calciphylaxis

Cutaneous vascular calcification. Perieccrine calcification as a diagnostic key for calciphylaxis

Prevalence and Clinical Characteristics of Calciphylaxis in Chinese Hemodialysis Patients

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

Contact Info

Product

Resources

About