Calciphylaxis: a rare cause of limb ulcer – a case report

Detalhes bibliográficos
Autor(a) principal: Cunha, Roberto
Data de Publicação: 2024
Outros Autores: Silva, Manuel, Carneiro, Vítor, Sousa, Pedro, Correia, Mafalda, Vieira, Isabel, Cássio, Isabel, Oliveira, Nelson, Dias, Emanuel
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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spelling 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
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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)
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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)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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