Fatal Calciphylaxis in Tertiary Hyperparathyroidism due to Long-Lasting End-Stage Renal Disease : A Case Report

Abstract

Calcific uremic arteriolopathy (also known as calciphylaxis) is a rare and highly lethal obliterative small vessel vasculopathy with characteristic dermatological manifestations. It is frequent in patients with end-stage renal disease undergoing hemodialysis and hyperparathyroidism. Although its pathogenesis is not completely understood, it is directly related to high serum calcium levels which leads to organ damage, predominantly in fatty tissue and deeper layers of the skin leading to extremely painful erythema with mottled reticular pattern or ulcerations with heterogeneous distribution. The treatment of calciphylaxis includes strict wound care and normalization of calcium/phosphorus homeostasis, furthermore a significant number of patients will need debridement. In this paper, we describe an unusual case of calciphylaxis in a 30-year-old woman with tertiary hyperparathyroidism due to parathyroid adenoma and parathyroid hyperplasia associated with end-stage renal disease. © 2024, Asian Association for Frailty and Sarcopenia and Taiwan Association for Integrated Care.