Clin Osteol 2019; 24(4): 205-215

Calciphylaxis as a multidisciplinary problem: important information (not only) for clinical osteologists and case reportsCase reports

Sulková Dusilová Sylvie^1,2, Šafránek Roman^1,2, Pokorná Anita¹, Soukup Tomáš³, Bělobrádková Martina³, Horáček Jiří⁶, Bláha Vladimír⁴, Palička Vladimír⁵

¹ Hemodialyzační středisko FN Hradec Králové

² Katedra interních oborů LF UK, Hradec Králové

³ II. interní gastroenterologická klinika LF UK a FN Hradec Králové

⁴ III. gerontometabolická klinika LF UK a FN Hradec Králové

⁵ Osteocentrum, Ústav klinické biochemie a diagnostiky LF UK a FN Hradec Králové

⁶ IV. interní hematologická klinika LF UK a FN Hradec Králové

Calciphylaxis (CUA -⁠ calcifying uremic arteriolopathy) is a serious clinical complications characterized by large and painful skin and subcutaneous tissue ulcerations and necrosis, associated with the risk of sepsis and mortality. Its pathogenesis is quite complicated. Despite it is a rare entity, physicians of all specialities may meet this disease. Therefore, this paper focuses on principal characteristics of CUA, risk factors in pathogenesis (namely calcium and phosphate metabolism disturbances, hyperparathyroidism, and association with warfarin therapy), as well as on therapeutics principles and possibilities. The most promising current therapy approach is administration of sodium thiosulfate. Three case reports are presented for illustration.

Keywords: warfarin; calcifying uremic arteriolopathy; calciphylaxis; hyperparathyroidism; matrix GLA mortality protein; sepsis; skin necrosis; sodium thiosulfate; surgical parathyroidectomy

Received: January 31, 2020; Accepted: February 10, 2019; Published: December 11, 2019  Show citation