Calciphylaxis: a rare cause of limb ulcer – a case report
BACKGROUND: Calciphylaxis is a rare disease with a poor prognosis predominantly found in end-stage renal disease patients treated with dialysis. This pathology most commonly presents with painful non-healing ulcers, predisposing to high risk of sepsis and death. The authors present a case of bilate...
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| Format: | Article |
| Language: | Portuguese |
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Sociedade Portuguesa de Angiologia e Cirurgia Vascular
2024-03-01
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| Series: | Angiologia e Cirurgia Vascular |
| Subjects: | |
| Online Access: | https://acvjournal.com/index.php/acv/article/view/546 |
| _version_ | 1797279335218937856 |
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| author | Roberto Cunha Manuel Silva Vítor Carneiro Pedro Sousa Mafalda Correia Isabel Vieira Isabel Cássio Nelson Oliveira Emanuel Dias |
| author_facet | Roberto Cunha Manuel Silva Vítor Carneiro Pedro Sousa Mafalda Correia Isabel Vieira Isabel Cássio Nelson Oliveira Emanuel Dias |
| author_sort | Roberto Cunha |
| collection | DOAJ |
| description |
BACKGROUND: Calciphylaxis is a rare disease with a poor prognosis predominantly found in end-stage renal disease patients treated with dialysis. This pathology most commonly presents with painful non-healing ulcers, predisposing to high risk of sepsis and death. The authors present a case of bilateral leg ulcers due to calciphylaxis.
CASE REPORT: A 40-year-old female patient presented with painful ulcers in both lower limbs, for two months. She had a history of end-stage renal disease, morbid obesity, severe hypertension, arterial fibrillation and secondary hyperparathyroidism. Duplex examination releveled biphasic curves in the foot arteries. The ankle-brachial index was carried out with a result of 1.1, obtaining a WIFi stage of 3 (2/0/2). Venous disease was excluded. A biopsy was obtained, revealing small thick-walled vessels with dystrophic calcification of the intima and media.
After surgical debridement, antibiotics directed at the superimposed infection were administered and local wound care with chemical debridement was performed. The ulcers healed completely after 8 weeks and there was no recurrence after 6 months.
CONCLUSION: The diagnosis is made by clinical and histological findings. Treatment involves a multidisciplinary approach with medical treatment and wound care. Drugs such as sodium thiosulphate and cinacalcet have shown good results in the healing of ulcers. Vascular surgeons, as they often deal with patients with leg ulcers, should be aware of calciphylaxis as a differential diagnosis when vascular disease is excluded.
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| first_indexed | 2024-03-07T16:23:49Z |
| format | Article |
| id | doaj.art-8ba2be6f00f24c3b9707ab9282137ec4 |
| institution | Directory Open Access Journal |
| issn | 1646-706X 2183-0096 |
| language | Portuguese |
| last_indexed | 2024-03-07T16:23:49Z |
| publishDate | 2024-03-01 |
| publisher | Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
| record_format | Article |
| series | Angiologia e Cirurgia Vascular |
| spelling | doaj.art-8ba2be6f00f24c3b9707ab9282137ec42024-03-03T23:40:55ZporSociedade Portuguesa de Angiologia e Cirurgia VascularAngiologia e Cirurgia Vascular1646-706X2183-00962024-03-0119410.48750/acv.546Calciphylaxis: a rare cause of limb ulcer – a case reportRoberto Cunha0Manuel Silva1Vítor Carneiro2Pedro Sousa3Mafalda Correia4Isabel Vieira5Isabel Cássio6Nelson Oliveira7Emanuel Dias8Serviço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, PortugalServiço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, Portugal BACKGROUND: Calciphylaxis is a rare disease with a poor prognosis predominantly found in end-stage renal disease patients treated with dialysis. This pathology most commonly presents with painful non-healing ulcers, predisposing to high risk of sepsis and death. The authors present a case of bilateral leg ulcers due to calciphylaxis. CASE REPORT: A 40-year-old female patient presented with painful ulcers in both lower limbs, for two months. She had a history of end-stage renal disease, morbid obesity, severe hypertension, arterial fibrillation and secondary hyperparathyroidism. Duplex examination releveled biphasic curves in the foot arteries. The ankle-brachial index was carried out with a result of 1.1, obtaining a WIFi stage of 3 (2/0/2). Venous disease was excluded. A biopsy was obtained, revealing small thick-walled vessels with dystrophic calcification of the intima and media. After surgical debridement, antibiotics directed at the superimposed infection were administered and local wound care with chemical debridement was performed. The ulcers healed completely after 8 weeks and there was no recurrence after 6 months. CONCLUSION: The diagnosis is made by clinical and histological findings. Treatment involves a multidisciplinary approach with medical treatment and wound care. Drugs such as sodium thiosulphate and cinacalcet have shown good results in the healing of ulcers. Vascular surgeons, as they often deal with patients with leg ulcers, should be aware of calciphylaxis as a differential diagnosis when vascular disease is excluded. https://acvjournal.com/index.php/acv/article/view/546CalciphylaxisCalcific uremic arteriolopathyEnd stage renal diseaseVascular surgery |
| spellingShingle | Roberto Cunha Manuel Silva Vítor Carneiro Pedro Sousa Mafalda Correia Isabel Vieira Isabel Cássio Nelson Oliveira Emanuel Dias Calciphylaxis: a rare cause of limb ulcer – a case report Angiologia e Cirurgia Vascular Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Vascular surgery |
| title | Calciphylaxis: a rare cause of limb ulcer – a case report |
| title_full | Calciphylaxis: a rare cause of limb ulcer – a case report |
| title_fullStr | Calciphylaxis: a rare cause of limb ulcer – a case report |
| title_full_unstemmed | Calciphylaxis: a rare cause of limb ulcer – a case report |
| title_short | Calciphylaxis: a rare cause of limb ulcer – a case report |
| title_sort | calciphylaxis a rare cause of limb ulcer a case report |
| topic | Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Vascular surgery |
| url | https://acvjournal.com/index.php/acv/article/view/546 |
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