Calciphylaxis

Revision as of 19:57, 20 November 2014 by Kxl328 (talk | contribs) (→‎Imaging)

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
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