Calciphylaxis in a Chronic Hemodialysis Patient with Protein S Deficiency
| Autor: | Lionel Rostaing, Dominique Durand, Claire Durand-Malgouyres, Hugues Ton-That, Marie-Bernadette Delisle, Jean-Michel Suc, Pierre Bories, Sondès El Feki, Jean-Louis Bonafe |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Hyperparathyroidism
medicine.medical_specialty Calciphylaxis Protein S Deficiency medicine.diagnostic_test business.industry medicine.medical_treatment Mitral valve replacement Middle Aged medicine.disease Surgery Subtotal Parathyroidectomy Renal Dialysis Nephrology Skin biopsy medicine Humans Kidney Failure Chronic Female Hemodialysis Protein S deficiency Panniculitis business |
| Zdroj: | American Journal of Nephrology. 15:524-527 |
| ISSN: | 1421-9670 0250-8095 |
| DOI: | 10.1159/000168900 |
| Popis: | Vascular calcifications are common in uremic patients whereas calciphylaxis is rare. We report the case of a 45-year-old woman on chronic hemodialysis since 1977. She had a subtotal parathyroidectomy in 1985, aortic and mitral valve replacement in 1986, and has been treated since then with nicoumalone. In June 1991, she presented with repeated, painful cutaneous necrosis suggesting panniculitis. A skin biopsy showed lobular panniculitis and evidence of calciphylaxis. There was an obvious biological hyperparathyroidism. Protein C functional level was in the normal range whereas protein S functional level was low, i.e. 42%. The patient underwent cervical surgery to remove two parathyroid glands, and daily hemodialysis sessions. Despite this treatment, cutaneous necrosis progressed with superinfection. A few weeks later, the patient died from a septic shock after a myocardic infarction. Necropsy was not performed. |
| Databáze: | OpenAIRE |
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