Calciphylaxis: a rare cause of limb ulcer – a case report
Autor(a) principal: | |
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Data de Publicação: | 2024 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.546 |
Resumo: | BACKGROUND: Calciphylaxis is a rare disease with a poor prognosis predominantly found in end-stage renal disease patients treated with dialysis. This pathology most commonly presents with painful non-healing ulcers, predisposing to high risk of sepsis and death. The authors present a case of bilateral leg ulcers due to calciphylaxis. CASE REPORT: A 40-year-old female patient presented with painful ulcers in both lower limbs, for two months. She had a history of end-stage renal disease, morbid obesity, severe hypertension, arterial fibrillation and secondary hyperparathyroidism. Duplex examination releveled biphasic curves in the foot arteries. The ankle-brachial index was carried out with a result of 1.1, obtaining a WIFi stage of 3 (2/0/2). Venous disease was excluded. A biopsy was obtained, revealing small thick-walled vessels with dystrophic calcification of the intima and media. After surgical debridement, antibiotics directed at the superimposed infection were administered and local wound care with chemical debridement was performed. The ulcers healed completely after 8 weeks and there was no recurrence after 6 months. CONCLUSION: The diagnosis is made by clinical and histological findings. Treatment involves a multidisciplinary approach with medical treatment and wound care. Drugs such as sodium thiosulphate and cinacalcet have shown good results in the healing of ulcers. Vascular surgeons, as they often deal with patients with leg ulcers, should be aware of calciphylaxis as a differential diagnosis when vascular disease is excluded. |
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Calciphylaxis: a rare cause of limb ulcer – a case reportCalciphylaxisCalcific uremic arteriolopathyEnd stage renal diseaseVascular surgeryBACKGROUND: Calciphylaxis is a rare disease with a poor prognosis predominantly found in end-stage renal disease patients treated with dialysis. This pathology most commonly presents with painful non-healing ulcers, predisposing to high risk of sepsis and death. The authors present a case of bilateral leg ulcers due to calciphylaxis. CASE REPORT: A 40-year-old female patient presented with painful ulcers in both lower limbs, for two months. She had a history of end-stage renal disease, morbid obesity, severe hypertension, arterial fibrillation and secondary hyperparathyroidism. Duplex examination releveled biphasic curves in the foot arteries. The ankle-brachial index was carried out with a result of 1.1, obtaining a WIFi stage of 3 (2/0/2). Venous disease was excluded. A biopsy was obtained, revealing small thick-walled vessels with dystrophic calcification of the intima and media. After surgical debridement, antibiotics directed at the superimposed infection were administered and local wound care with chemical debridement was performed. The ulcers healed completely after 8 weeks and there was no recurrence after 6 months. CONCLUSION: The diagnosis is made by clinical and histological findings. Treatment involves a multidisciplinary approach with medical treatment and wound care. Drugs such as sodium thiosulphate and cinacalcet have shown good results in the healing of ulcers. Vascular surgeons, as they often deal with patients with leg ulcers, should be aware of calciphylaxis as a differential diagnosis when vascular disease is excluded.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2024-03-03info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.546https://doi.org/10.48750/acv.546Angiologia e Cirurgia Vascular; Vol. 19 No. 4 (2023): December; 235-238Angiologia e Cirurgia Vascular; Vol. 19 N.º 4 (2023): Dezembro; 235-2382183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/546http://acvjournal.com/index.php/acv/article/view/546/364Copyright (c) 2024 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessCunha, RobertoSilva, ManuelCarneiro, VítorSousa, PedroCorreia, MafaldaVieira, IsabelCássio, IsabelOliveira, NelsonDias, Emanuel2024-03-08T10:30:14Zoai:ojs.acvjournal.com:article/546Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:13:56.860105Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Calciphylaxis: a rare cause of limb ulcer – a case report |
title |
Calciphylaxis: a rare cause of limb ulcer – a case report |
spellingShingle |
Calciphylaxis: a rare cause of limb ulcer – a case report Cunha, Roberto Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Vascular surgery |
title_short |
Calciphylaxis: a rare cause of limb ulcer – a case report |
title_full |
Calciphylaxis: a rare cause of limb ulcer – a case report |
title_fullStr |
Calciphylaxis: a rare cause of limb ulcer – a case report |
title_full_unstemmed |
Calciphylaxis: a rare cause of limb ulcer – a case report |
title_sort |
Calciphylaxis: a rare cause of limb ulcer – a case report |
author |
Cunha, Roberto |
author_facet |
Cunha, Roberto Silva, Manuel Carneiro, Vítor Sousa, Pedro Correia, Mafalda Vieira, Isabel Cássio, Isabel Oliveira, Nelson Dias, Emanuel |
author_role |
author |
author2 |
Silva, Manuel Carneiro, Vítor Sousa, Pedro Correia, Mafalda Vieira, Isabel Cássio, Isabel Oliveira, Nelson Dias, Emanuel |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Cunha, Roberto Silva, Manuel Carneiro, Vítor Sousa, Pedro Correia, Mafalda Vieira, Isabel Cássio, Isabel Oliveira, Nelson Dias, Emanuel |
dc.subject.por.fl_str_mv |
Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Vascular surgery |
topic |
Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Vascular surgery |
description |
BACKGROUND: Calciphylaxis is a rare disease with a poor prognosis predominantly found in end-stage renal disease patients treated with dialysis. This pathology most commonly presents with painful non-healing ulcers, predisposing to high risk of sepsis and death. The authors present a case of bilateral leg ulcers due to calciphylaxis. CASE REPORT: A 40-year-old female patient presented with painful ulcers in both lower limbs, for two months. She had a history of end-stage renal disease, morbid obesity, severe hypertension, arterial fibrillation and secondary hyperparathyroidism. Duplex examination releveled biphasic curves in the foot arteries. The ankle-brachial index was carried out with a result of 1.1, obtaining a WIFi stage of 3 (2/0/2). Venous disease was excluded. A biopsy was obtained, revealing small thick-walled vessels with dystrophic calcification of the intima and media. After surgical debridement, antibiotics directed at the superimposed infection were administered and local wound care with chemical debridement was performed. The ulcers healed completely after 8 weeks and there was no recurrence after 6 months. CONCLUSION: The diagnosis is made by clinical and histological findings. Treatment involves a multidisciplinary approach with medical treatment and wound care. Drugs such as sodium thiosulphate and cinacalcet have shown good results in the healing of ulcers. Vascular surgeons, as they often deal with patients with leg ulcers, should be aware of calciphylaxis as a differential diagnosis when vascular disease is excluded. |
publishDate |
2024 |
dc.date.none.fl_str_mv |
2024-03-03 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.546 https://doi.org/10.48750/acv.546 |
url |
https://doi.org/10.48750/acv.546 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/546 http://acvjournal.com/index.php/acv/article/view/546/364 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2024 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2024 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 19 No. 4 (2023): December; 235-238 Angiologia e Cirurgia Vascular; Vol. 19 N.º 4 (2023): Dezembro; 235-238 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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