Author/Authors :
hanna, r.m. University of California, Los Angeles - David Geffen School of Medicine, Ronald Regan UCLA Medical Center, Olive-View UCLA Medical Center - Division of Nephrology, Department of Medicine, USA , nabil, j.r. University of California, Los Angeles - David Geffen School of Medicine, Ronald Regan UCLA Medical Center - Division of Nephrology, USA , lopez, e.a. University of California, Los Angeles - Olive-View UCLA Medical Center - Department of Medicine, USA , corry, d.b. University of California, Los Angeles - David Geffen School of Medicine, Ronald Regan UCLA Medical Center, Olive-View UCLA Medical Center - Division of Nephrology, Department of Medicine, USA , wilson, j. University of California, Los Angeles - David Geffen School of Medicine, Ronald Regan UCLA Medical Center, Olive-View UCLA Medical Center - Division of Nephrology, Department of Medicine, USA
Abstract :
Calciphylaxis has seldom been reported in patients with acute renal failure or in pre-dialysis patients. It also has been reported at lower calcium phosphorous products and in patients with adynamic bone disease. We report a pre-hemodialysis (HD) patient with acute renal failure and biopsy-proven calciphylaxis involving multiple cutaneous sites with calcification of the perineal area resulting in dry gangrene of the penis that necessitated a partial penectomy. The patient had elevated serum calcium,phosphorous and parathyroid hormone level of 612 pg/mL. The same patient suffered subsequently from a calcium embolus that occluded his left ophthalmic artery and resulted in left eye blindness. Calciphylaxis is a devastating phenomenon and physicians should have a high clinical suspicion for it in HD patients as well as in patients with late stages of chronic kidney disease.
