Calciphylaxis: Difference between revisions
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==Imaging== | ==Imaging== | ||
*Plain radiographs - arborization of vascular calcification within dermis and subQ tissues | |||
==Tx== | |||
*Medical | |||
Revision as of 19:57, 20 November 2014
Background
- Most commonly HD/ESRD patients (1% of ESRD)
- No available data in general population (non-uremic calciphylaxis)
- Calcium and phosphate levels rise beyond solubility and precipitate in arteries
- May be increasing due to widespread IV vitamin D
- Mortality as high as 60-80%; sepsis from necrotic skin lesions
Features
- Very painful lesions develop suddenly and progress rapidly
- Dermatolgic appearances:
- Livedo reticularis
- Stellate purpura
- Usually LEs, hands, or torso
DDx
- Brown recluse spider bite
- Bullous Pemphigoid
- Cellulitis, necrotizing fasciitis
- Erythema Nodosum
- Vasculitis
- Venous ulcers
Labs
- Serum PTH level
- CBC, CMP, phosphate, coags
- Inpatient - hepatitis panel, cryofibrinogen level, lipase, ESR, CRP, ANA, ANCA
Imaging
- Plain radiographs - arborization of vascular calcification within dermis and subQ tissues
Tx
- Medical