A Dialysis Patient with Systemic Calciphylaxis Exhibiting Rapidly Progressive Visceral Ischemia and Acral Gangrene

Masahito TAMURA; Kinya HIROSHIGE; Akihiko OSAJIMA; Masasuke SOEJIMA; Masayuki TAKASUGI; Akio KUROIWA

doi:10.2169/internalmedicine.34.908

Masahito TAMURA, Kinya HIROSHIGE, Akihiko OSAJIMA, Masasuke SOEJIMA, Masayuki TAKASUGI, Akio KUROIWA

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Keywords: medial arterial calcification, diabetes mellitus, secondary hyperparathyroidism, corticosteroid

JOURNAL FREE ACCESS

1995 Volume 34 Issue 9 Pages 908-912

DOI https://doi.org/10.2169/internalmedicine.34.908

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Abstract

Systemic calciphylaxis is a rare, poorly understood syndrome of progressive peripheral ischemic necrosis and medial arterial calcification in patients with end-stage renal disease. We report a patient with this syndrome which developed following corticosteroid administration and who ultimately required amputation of the four extremities. Furthermore, cerebral, myocardial, splenic, and intestinal infarctions also developed in parallel with the increment of visceral arterial calcification. No evidence of noticeable hyperparathyroidism or elevation of serum calcium-phosphate product was observed. We speculated that, in addition to diabetes mellitus and chronic renal failure while undergoing dialysis therapy, the administration of corticosteroids might act synergistically to cause calciphylaxis.
(Internal Medicine 34: 908-912, 1995)

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