A case of non‐uremic calciphylaxis associated with systemic lupus erythematosus and antiphospholipid syndrome

Calciphylaxis and its co‐occurrence with connective tissue diseases

“…76 Clinicians should carefully assess the disease activity of patients and weigh the advantages and disadvantages before taking action. In these cases, intravenous STS was the most commonly used treatment, 3,77 followed by oral bisphosphonates, 58 hyperbaric oxygen, 12 surgical debridement, 61 and thyroidectomy 60 Among the 28 patients with a known prognosis, 9 improved (32%), and 18 progressed or died (64%). Among the 13 patients treated with STS, all had a good prognosis.…”

“…We searched PubMed and found 28 connective tissue disease‐related calciphylaxis reports published as of August 2022, in which most of the patients were middle‐aged women. Among the connective tissue diseases, systemic lupus erythematosus (SLE) is most often associated with calciphylaxis (approximately 54%), 3,57 followed by calciphylaxis with rheumatoid arthritis (approximately 29%) 12,58,59 . There are also cases of calciphylaxis with giant cell arteritis, antiphospholipid syndrome, and psoriatic arthritis 60–62 .…”

“…Currently, most cases of calciphylaxis are in patients with end‐stage renal disease (ESRD), who require dialysis. However, it can also occur in other diseases with normal renal function, including autoimmune disease, 3 polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome, 4 cancer, 5 and coronavirus disease 2019 6 . Calciphylaxis not only involves the skin but also the heart, 7 lungs, 8 and other internal organs 9 .…”

Nonuremiccalciphylaxis - A Systematic Review

“…Other morbidities among the included studies were warfarin induced (7.54 %) [23,24,25 1). Similarly, other remaining etiological conditions were; primary hyperparathyroidism [35], malignancy [36], glucocorticoid [37], stage IV non-Hodgkin lymphoma [38], chronic kidney disease [39], acenocumarol use [40], weight loss and hypotension [41], rheumatoid arthritis and hypotension [42], diuretic therapy [43], diabetes mellitus type-II [44], psoriasis [45], rheumatologic disease [46], multiple myeloma and rheumatoid arthritis [47], alcoholic hepatitis [48], covid-19 [49], liver transplant [50], SLE and antiphospholipid antibody syndrome (APS) [51], recombinant human parathyroid hormone therapy (PTH) [52], autoimmune disease [53], coumarin necrosis and vasculitis [54], neuroendocrine tumor (NET) [55], rheumatoid arthritis [56]. In addition, majority of the wounds of NUC were seen on legs (n = 20, 37.73 %), thighs (n = 16, 30.18), calves (n = 7, 13.20 %), breast (n = 4, 7.54 %) as well as buttocks (n = 4, 7.54 %), respectively.…”

“…Similarly, corticosteroid therapy was used in only five cases (9.43 %), while most of the studies (54.71 %) reported intravenous sodium thiosulfate (IV -ST) injection as a baseline treatment for NUC. Some other treatment strategies among the included cases were hyperbaric oxygen therapy [51,50,7], cannabis-based medicine [21], IV -pamidronate [45], doxycycline combined with zoledronic acid and Rivaroxaban [15], as well as heparin [31, 51,57] individually or combined with other medicines, respectively. Moreover, the duration of complete resolution of skin lesion ranged from 2 months to 3 years.…”