Gastrointestinal calciphylaxis: a rare and devastating complication in end-stage kidney disease.

Autor: Aarabi A; Gosford Hospital, Gosford, NSW, Australia. amiraarabi@hotmail.co.uk., Kumar K; Gosford Hospital, Gosford, NSW, Australia.
Jazyk: angličtina
Zdroj: CEN case reports [CEN Case Rep] 2024 Nov 14. Date of Electronic Publication: 2024 Nov 14.
DOI: 10.1007/s13730-024-00944-5
Abstrakt: Calciphylaxis, also known as calcific uremic arteriolopathy, is a rare and severe condition that predominantly affects individuals with end-stage kidney disease (ESKD). It manifests through vascular calcifications that precipitate tissue necrosis, with cutaneous manifestations being common. However, gastrointestinal involvement is an infrequent but gravely serious occurrence. In this report, we present an atypical case of gastrointestinal (GI) calciphylaxis in a 66-year-old woman undergoing peritoneal dialysis. The patient's initial symptoms of abdominal pain and turbid peritoneal fluid raised suspicions of bacterial peritonitis. Despite therapeutic interventions, the patient's condition deteriorated. Computed tomography (CT) imaging revealed a perforation in the caecal wall, necessitating emergency surgical intervention. Histopathology post-surgery confirmed the diagnosis of GI calciphylaxis. The patient's postoperative trajectory was fraught with complications, ultimately leading to a fatal outcome. This case highlights the importance of vigilance for calciphylaxis in the differential diagnosis when abdominal pain develops in patients with ESKD, regardless of the presence of typical skin symptoms. Prompt detection and an integrated care approach are essential for improved prognosis. Further research is needed to find more efficacious treatments for this devastating illness.
Competing Interests: Declarations Conflict of interest Not applicable. Ethical approval and Consent to participate The conduct of this study was in accordance with the ethical principles set forth in the Declaration of Helsinki. The research protocol received approval from the Gosford Hospital Ethics Committee, underlining the ethical rigour of the investigation. Consent for Publication Written informed consent was obtained from the patient’s husband (next of kin) following her death.
(© 2024. Crown.)
Databáze: MEDLINE
Externí odkaz: