Abstract
Calciphylaxis, a rare syndrome that causes skin necrosis, mainly affects patients undergoing hemodialysis; the annual incidence rate is 0.04% to 4%, and the mortality rate is 60% to 80%. The pathogenesis is multifactorial; it depends on the factors that cause calcification, such as alteration of calcium metabolism, phosphorus, hyperparathyroidism, female sex, diabetes, obesity; from the clinical point of view, calciphylaxis can progress from a painful purpura to extensive skin necrosis, causing death from sepsis. Treatment is based on wound care and elimination of the factors. Thus, a clinical case is presented of a 64-year-old woman with a history of chronic kidney disease, diabetes, criteria for urgent dialysis, presence of skin lesions on the lower limbs, with suspicion of calciphylaxis, confirmed by anatomopathology, presenting an unfavorable evolution, with an increase in the size of the skin lesions, poor prognosis and mortality.
References
Bailleux, S., Collins, P., & Nikkels, A. F. (2022). The relevance of skin biopsies in general internal medicine: Facts and myths. Dermatology and Therapy, 12(5),1103-1119. https:/doi.org/10.1007/s13555-022-00717-x
Cucchiari, D., & Torregrosa, J.-V. (2022). Calcifilaxis en pacientes con enfermedad renal crónica: una enfermedad todavía desconcertante y potencialmente mortal. Nefrología (English Edition), 38(6), 579-586. https://doi.org/10.1016/j.nefro.2018.05.007
Fernández, M., Morales, E., Gutierrez, E., Polanco, N., Hernández, E., Mérida, E., & Praga, M. (2024). Nefrologia: Publicacion Oficial de La Sociedad Espanola Nefrologia, 37(5), 501-507. https://doi.org/10.1016/j.nefro.2017.02.006
Fornes-Pujalte, B., Pastor-Orduña, M. I., Díez-Fornes, P., Sierra-Talamantes, C., Palomar-Albert, D., Zamora-Ortiz, J., & Palomar-Llatas, F. (2019). Úlceras por calcifilaxis: ¿Cuidados paliativos o desbridamiento? https://doi.org/10.5281/ZENODO.2915540
Gholizadeh Ghozloujeh, Z., Rajasekaran, A., Abdipour, A., & Norouzi, S. (2023). Calciphylaxis in a patient with lupus nephritis and acute kidney injury: A rare case report and literature review. Journal of Investigative Medicine High Impact Case Reports, 11. https://doi.org/10.1177/23247096231215705
Gupta, K., Suthar, P. P., Bhave, N., Singh, J. S., Venkatraman, S. M. K., & Jadhav, R. B. (2024). Potential role of bone scintigraphy in the diagnosis of calciphylaxis. World Journal of Nuclear Medicine, 23(1), 3-9. https://doi.org/10.1055/s-0043-1760760
Huang, C., Duan, Z., Xu, C., & Chen, Y. (2023). Influence of sodium thiosulfate on coronary artery calcification of patients on dialysis: a meta-analysis. Renal Failure, 45(2), 2254569. https://doi.org/10.1080/0886022X.2023.2254569
Kodumudi, V., Jeha, G. M., Mydlo, N., & Kaye, A. D. (2020). Management of cutaneous calciphylaxis. Advances in Therapy, 37(12), 4797-4807. https://doi.org/10.1007/s12325-020-01504-w
Liang, S., Guan, M., Liu, Z., Ruan, X., Huang, H., & Zhong, H. (2023). Sailing between scylla and charybdis-anticoagulation dilemma in a patient with calciphylaxis and mechanical cardiac valve replacement: a case report and literature review. Renal Failure, 45(2). https://doi.org/10.1080/0886022x.2023.2264401
Liu, Y., & Zhang, X. (2023). Early diagnosis strategy of calciphylaxis in dialysis patients. Renal Failure, 45(2), 2264407. https://doi.org/10.1080/0886022X.2023.2264407
Mendoza Panta, D. A., Huertas Garzón, J. W., & Osorio Chuquitarco, W. X. (2019). Calcifilaxis en terapia de sustitución renal. Revista colombiana de nefrología, 6(1), 69. https://doi.org/10.22265/acnef.6.1.327
Mormile, I., Mosella, F., Turco, P., Napolitano, F., de Paulis, A., & Rossi, F. W. (2023). Calcinosis cutis and calciphylaxis in autoimmune connective tissue diseases. Vaccines, 11(5). https://doi.org/10.3390/vaccines11050898
Prats, V. T., & Cucchiari, D. (2024). Calcifilaxis. Nefrologiaaldia.org. Recuperado el 1 de febrero de 2025, de https://nefrologiaaldia.org/es-articulo-calcifilaxis-183-pdf
Roy, S., Reddy, S. N., Garcha, A. S., Vantipalli, P., Patel, S. S., Ur Rahman, E., & Adapa, S. (2021). Successful treatment of calciphylaxis in a young female with end-stage renal disease on peritoneal dialysis with parathyroidectomy, intensification of dialysis, and sodium thiosulphate-A case report and literature review. Journal of Investigative Medicine High Impact Case Reports, 9, 23247096211060580. https://doi.org/10.1177/23247096211060580
Ruiz-Granados, E. S., Herrera, J. M., & García, L. M. (2024). Calcifilaxis en una paciente sin insuficiencia renal avanzada. Revista clínica de medicina de familia, 10(2), 150-153. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1699-695X2017000200150
Torre, A. C., Bastard, D. P., Diehl, M., & Rosa-Diez, G. (2024). CALCIFILAXIS, FACTORES DE RIESGO, TRATAMIENTO Y EVOLUCIÓN ESTUDIO RETROSPECTIVO DE 39 PACIENTES. Medicinabuenosaires.com. Recuperado el 1 de febrero de 2025, de https://www.medicinabuenosaires.com/revistas/vol84-24/n2/196.pdf
Wickens, O., Rengarajan, S., Chinnadurai, R., Ford, I., Macdougall, I. C., Kalra, P. A., & Sinha, S. (2024). The role of iron in calciphylaxis-A current review. Journal of Clinical Medicine, 11(19), 5779. https://doi.org/10.3390/jcm11195779
Wu, J., Chen, L., Dang, F., Zha, P., Li, R., & Ran, X. (2023). Refractory wounds induced by normal-renal calciphylaxis: An under-recognised calcific arteriolopathy. International Wound Journal, 20(4), 1262-1275. https://doi.org/10.1111/iwj.13951
Yoshiko, Y., & Vucenik, I. (2024). Inositol hexaphosphate in bone health and disease. Biomolecules, 14(9), 1072. https://doi.org/10.3390/biom14091072
Zalazar, M. E., Landau, D. C., Valente, E., Ruiz Lascano, A., & Kurpis, M. (2024). Calcific uremic arteriolopathy. A case report. Medigraphic.com. Recuperado el 1 de febrero de 2025, de https://www.medigraphic.com/pdfs/cutanea/mc-2019/mc192g.pdf

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