Kalziphylaxie

Brandenburg, Vincent; Martin, Heike; Sohn, C; Ketteler, Markus

doi:10.1055/s-0041-100834

Cited by 13 publications

(14 citation statements)

References 4 publications

(6 reference statements)

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“…5 However, there is even discussion whether performing deep skin biopsy may worsen the clinical course 30,31 and too intensive manipulation is not advised. 1 Hyperbaric oxygen therapy (HBOT) might be an adjunctive topical treatment option, but is only available in a small number of specialised centres. In a retrospective analysis of 34 patients with uremic CP, HBOT was very effective with 50% complete wound healing and 58% improvement.…”

Section: Treatmentmentioning

confidence: 99%

“…Due to the multimorbidity and limited mobility of CP patients, randomized controlled trials in specialized centers are highly restricted in terms of patient acquisition. 1 Systematic data collection might be supported by clinical registers like the German Calciphylaxis Network (www.calciphylaxis.net) (NCT02635373). 34 In CP patients with hemodialysis, the calcium-phosphate product might be positively influenced by changes in frequency, duration or method of blood filtration.…”

Section: Systemic Treatmentmentioning

confidence: 99%

“…Around 1% of patients depending on hemodialysis suffer from CUA. 1 Most of the studies dealing with CP were performed in patients with CUA. Typically, in the histological analysis of a deep scalpel biopsy with skin and subcutaneous tissue one can find the trias of calcification of the media layer of small cutaneous vessels, intimal hyperplasia/fibrosis and thrombotic occlusion.…”

mentioning

confidence: 99%

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<p>Management of patients with calciphylaxis: current perspectives</p>

Erfurt‐Berge¹,

Renner²

2019

CWCMR

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Calciphylaxis (CP) is a rare disorder presenting with painful ischemic skin ulcerations. Its association with end-stage renal disease, but also non-uremic cases have been described. Several risk factors, like metabolic syndrome, calcium-phosphate imbalance, anticoagulative medication and female gender have been discussed. Multidisciplinary therapeutic approaches are necessary since evidence-based guidelines are missing due to lack of pathophysiological understanding of the disease and the absence of studies with large patient cohorts. However, strategies for local wound therapy, reduction of risk factors and systemic therapies are being developed. Changes in duration, frequency and method of hemodialysis and specific medication to lower the calcium upload can be effective in uremic CP cases. Systemic treatments with cinacalcet, sodium thiosulfate or bisphosphonates have been applied successfully in CP patients, but large placebo-controlled randomized trials are still needed to gather better insight into this fatal disease.

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Section: Treatmentmentioning

confidence: 99%

Section: Systemic Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

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<p>Management of patients with calciphylaxis: current perspectives</p>

Erfurt‐Berge¹,

Renner²

2019

CWCMR

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“…Zur interdisziplinären Versorgung einer Calciphylaxie gehört eine oft monatelange palliative Schmerztherapie . Das Risikoprofil dieser Patienten und der Krankheitsprogress bestimmen die Opioidgabe (z.…”

Section: Ulcus Crurisunclassified

Schmerzen und Schmerztherapie in der Dermatologie

Beiteke

Bigge

Reichenberger³

et al. 2015

J Deutsche Derma Gesell

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“…The most common presentation is the painful violaceous mottling of the skin, resembling livedo reticularis [ 2 , 4 ]. However, calciphylaxis rarely manifests with gastrointestinal complications [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Bleeding Secondary to Calciphylaxis

et al. 2015

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Patient: Female, 66Final Diagnosis: CalciphylaxisSymptoms: Gastrointesinal haemorrhageMedication: NoneClinical Procedure: Hemodialysis • blood transfusionsSpecialty: Gastroenterology and HepatologyObjective:Rare diseaseBackground:Calciphylaxis is associated with a high mortality that approaches 80%. The diagnosis is usually made when obvious skin lesions (painful violaceous mottling of the skin) are present. However, visceral involvement is rare. We present a case of calciphylaxis leading to lower gastrointestinal (GI) bleeding and rectal ulceration of the GI mucosa.Case Report:A 66-year-old woman with past medical history of diabetes mellitus, hypertension, end-stage renal disease (ESRD), recently diagnosed ovarian cancer, and on hemodialysis (HD) presented with painful black necrotic eschar on both legs. The radiograph of the legs demonstrated extensive calcification of the lower extremity arteries. The hospital course was complicated with lower GI bleeding. A CT scan of the abdomen revealed severe circumferential calcification of the abdominal aorta, celiac artery, and superior and inferior mesenteric arteries and their branches. Colonoscopy revealed severe rectal necrosis. She was deemed to be a poor surgical candidate due to comorbidities and presence of extensive vascular calcifications. Recurrent episodes of profuse GI bleeding were managed conservatively with blood transfusion as needed.Following her diagnosis of calciphylaxis, supplementation with vitamin D and calcium containing phosphate binders was stopped. She was started on daily hemodialysis with low calcium dialysate bath as well as intravenous sodium thiosulphate. The clinical condition of the patient deteriorated. The patient died secondary to multiorgan failure.Conclusions:Calciphylaxis leading to intestinal ischemia/perforation should be considered in the differential diagnosis in ESRD on HD presenting with abdominal pain or GI bleeding.

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Kalziphylaxie

Cited by 13 publications

References 4 publications

<p>Management of patients with calciphylaxis: current perspectives</p>

<p>Management of patients with calciphylaxis: current perspectives</p>

Schmerzen und Schmerztherapie in der Dermatologie

Gastrointestinal Bleeding Secondary to Calciphylaxis

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