Calciphylaxis presenting as digital ischemia

Kazanji, Noora; Falatko, John; Neupane, Saroj; Reddy, G. S. R.

doi:10.1007/s11739-014-1172-6

Cited by 12 publications

(4 citation statements)

References 3 publications

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“…The delayed diagnosis caused by clinicians' insufficient understanding of calciphylaxis contributes to this serious illness condition. The predilection sites of calciphylaxis are soft and fatty tissues, for instance, the abdomen, buttocks and thighs [1,4], although necrosis of the extremities such as fingers [15] and penises [16,17] is also constantly reported. Davis et al conducted a literature review and found that obesity was identified as a risk factor in six of the eight studies reviewed [18].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

et al. 2021

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Introduction: Calciphylaxis is a rare but potentially fatal disease commonly occurred in dialysis patients. Despite some previous studies on risk factors for calciphylaxis, there is still a lack of data from Chinese population. Methods: The retrospective matched case-control study about calciphylaxis was performed in Zhongda Hospital affiliated to Southeast University. The case group involved 20 hemodialysis patients who were newly diagnosed with calciphylaxis from October 2017 to December 2018. The 40 noncalciphylaxis patients undergoing dialysis with the same age and duration of dialysis were randomly selected as controls. Results: Most of calciphylaxis patients were male and elderly, while overweight people were more susceptible to the disease. Although incidence of secondary hyperparathyroidism was higher in calciphylaxis patients, the differences in duration of elevated serum intact parathyroid hormone (iPTH) and its highest value did not reach statistical significance compared with controls. No significant difference in warfarin therapy was discernible between two groups. The univariate regression analysis indicated that male, score of use of activated vitamin D and its analogues, corrected serum calcium level, serum phosphate, Ca Â P product, iPTH, albumin, and alkaline phosphatase (ALP) level were significantly associated with calciphylaxis. Elevated levels of serum phosphate (OR 4.584, p ¼ 0.027) and ALP (OR 1.179, p ¼ 0.036), decreased level of serum albumin (OR 1.330, p ¼ 0.013) were independent risk factors after multivariate analysis. Conclusion: This is the first report of risk factors associated with calciphylaxis in China. Increased levels of serum phosphate and ALP, decreased level of serum albumin were vital high-risk factors for calciphylaxis in Chinese hemodialysis population.

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Section: Discussionmentioning

confidence: 99%

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

et al. 2021

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“…However, multiple case reports have described an atypical presentation in the form of acral ischemia with both genital and digital involvement. [6][7][8] The morphology of lesions is due to the anatomy of the cutaneous vasculature, which consists of central arterioles arising perpendicularly from vessels in the fascia. Each arteriole supports a 1-to 4-cm-diameter zone of the skin.…”

Section: Physical Examinationmentioning

confidence: 99%

Calciphylaxis: Controversies in Pathogenesis, Diagnosis and Treatment

Jeong

Domínguez

2016

The American Journal of the Medical Sciences

132

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Calcific uremic arteriolopathy, otherwise known as calciphylaxis, is a rare disease characterized by skin ulceration and tissue necrosis, likely the result of vascular calcification with accompanying intimal hypertrophy and small vessel thrombosis. Although most often associated with end-stage renal disease, it has also been seen in a number of other disorders (collectively referred to as nonuremic calciphylaxis). The purpose of this review is to summarize and analyze the currently available literature regarding the pathophysiology, risk factors, clinical presentation, diagnostic features and treatment modalities for this exceptionally uncommon illness. A series of recommended treatments is proposed for optimal treatment of calciphylaxis lesions.

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“…Diagnosis remains a real challenge and consequently evaluation of aetiologies and determination of therapeutic strategies has proved difficult. [1][2][3][4][5] The incidence of UEDI is about 2 cases per 100,000 persons per year. [6,7] The frequency of symptomatic UEDI is forty times less than the frequency of lower limb ischaemia.…”

Section: Introductionmentioning

confidence: 99%

“…Upper extremity digital ischaemia (UEDI) is a peripheral arterial disease. Diagnosis remains a real challenge and consequently evaluation of aetiologies and determination of therapeutic strategies has proved difficult [1–5] . The incidence of UEDI is about 2 cases per 100,000 persons per year [6,7] .…”

Section: Introductionmentioning

confidence: 99%

Digital ischaemia aetiologies and mid-term follow-up

Raimbeau¹,

Pistorius²,

Gouëffic³

et al. 2021

Medicine

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Upper extremity digital ischaemia (UEDI) is a rare heterogeneous condition whose frequency is 40 times less than that of toe ischaemia. Using a large cohort, the aim of this study was to evaluate aetiologies, prognosis and midterm clinical outcomes of UEDI. All patients with UEDI with or without cutaneous necrosis in a university hospital setting between January 2000 to December 2016 were included. Aetiologies, recurrence of UEDI, digital amputation and survival were analyzed retrospectively. Three hundred twenty three patients were included. UEDI due to cardio-embolic disease (DICE) was the highest occurring aetiology with 59 patients (18.3%), followed by DI due to Systemic Sclerosis (SSc) (16.1%), idiopathic causes (11.7%), Thromboangiitis obliterans (TAO) (9.3%), iatrogenic causes (9.3%), and cancer (6.2%). DICE patients tended to be older and featured more cases with arterial hypertension whereas TAO patients smoked more tobacco and cannabis. During follow-up, recurrences were significantly more frequent in SSc than in all other tested groups ( P < .0001 vs idiopathic and DICE, P = .003 vs TAO) and among TAO patients when compared to DICE patients ( P = .005). The cumulated rate of digital amputation was higher in the SSc group (n = 18) ( P = .02) and the TAO group (n = 7) ( P = .03) than in DICE (n = 2). This retrospective study suggests that main aetiologies of UEDI are DICE, SSc and idiopathic. This study highlights higher frequency of iatrogenic UEDI than previous studies. UEDI associated with SSc has a poor local prognosis (amputations and recurrences) and DICE a poor survival. UEDI with SSc and TAO are frequently recurrent.

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Calciphylaxis presenting as digital ischemia

Cited by 12 publications

References 3 publications

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

Calciphylaxis: Controversies in Pathogenesis, Diagnosis and Treatment

Digital ischaemia aetiologies and mid-term follow-up

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