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Calciphylaxis

Cindy H. Ma, M.D. and Nancy Nguyen, DO Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Rare, highly morbid, obliterative vasculopathy, characterized by ischemic or necrotic skin lesions

  • Uremic calciphylaxis (more common): calciphylaxis in patients with renal failure nea...

DIAGNOSIS

  • Diagnosis is primarily based on clinical suspicion with characteristic skin findings in ESRD patients with risk factors.

  • Lab studies are not useful for diagnostic purposes.

  • Imaging studies dem...

TREATMENT

GENERAL MEASURES

  • Multidisciplinary approach involving nephrology, dermatology, dermatopathology, wound care, nutrition, pain management, palliative medicine, plastic surgery

  • Aggressive control...

ONGOING CARE

PROGNOSIS

  • High morbidity and mortality

    • Infectious morbidity within weeks of diagnosis and death within months are common.

    • 1-year mortality 45–80%

    • Higher mortality with ulcerative lesions (65–...

REFERENCES

1
Fine  A, Zacharias  J. Calciphylaxis is usually non-ulcerating: risk factors, outcome and therapy. Kidney Int.  2002;61(6):2210–2217. [View Abstract on OvidMed...

ADDITIONAL READING

  • el-Azhary  RA, Arthur  AK, Davis  MD, et al. Retrospective analysis of tissue plasminogen activator as an adjuvant treatment for calciphylaxis. JAMA Derma...

CODES

ICD10

E83.59 Other disorders of calcium metabolism 

SNOMED

237900002 Calciphylaxis (disorder) 

CLINICAL PEARLS

  • Calciphylaxis is a highly morbid systemic condition of uncertain pathogenesis, primarily affecting the skin that is almost unique to the ESRD population, often confused with ulcerative...

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