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Calciphylaxis

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https://www.readbyqxmd.com/read/29147170/clinical-assessment-of-warfarin-therapy-in-patients-with-maintenance-dialysis-clinical-efficacy-risks-and-development-of-calciphylaxis
#1
Hajime Hasegawa
Recent years, multiple studies regarding clinical efficacy and risks of Warfarin therapy in dialysis patients have been reported, and not a few reports conclude that clinical advantage of Warfarin is questionable in dialysis patients. Conversely, its hemorrhagic risk might be a little more serious in dialysis patients comparing to non-dialysis patients. Basically, it is assumed that long-term administration of Warfarin accelerates the development of vascular athelosclerosis because of the abolished anti-calcification effect of Gla-protein activation by decreased vitamin K activity...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29130990/increased-bone-morphogenetic-protein-signaling-in-the-cutaneous-vasculature-of-patients-with-calciphylaxis
#2
Sagar U Nigwekar, Pawina Jiramongkolchai, Florian Wunderer, Emily Bloch, Rika Ichinose, Rosalynn M Nazarian, Ravi I Thadhani, Rajeev Malhotra, Donald B Bloch
BACKGROUND: The objective of this study was to investigate the role of bone morphogenetic protein (BMP) signal transduction in the pathogenesis of calciphylaxis. METHODS: Skin biopsy specimens were obtained from 18 patients with, and 12 patients without, calciphylaxis. Tissue sections were stained with antibodies directed against BMP effector proteins phosphorylated-SMAD (p-SMAD) 1/5/9, inhibitor of DNA 1 (Id1), inhibitor of DNA 3 (Id3), and Runx2. The intensity of staining was scored semi-quantitatively as strong versus weak or absent...
November 9, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130965/calciphylaxis-another-piece-of-the-puzzle
#3
Vincent M Brandenburg, Smeeta Sinha
No abstract text is available yet for this article.
November 9, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29107132/staged-urethroplasty-for-penile-urethral-strictures-from-lichen-sclerosus-and-failed-hypospadias-repair
#4
Bradley D Figler, Andrew Gomella, Logan Hubbard
OBJECTIVE: To present our technique for staged urethroplasty with buccal mucosa graft. METHODS: The patient presented is a 42 year-old male with a history of congenital hypospadias repaired as a child. He developed a penile urethral stricture at age 30 and was managed with self intermittent dilation. Recently, dilation became more difficult, and he was referred for reconstruction. Work-up revealed a high-grade stricture extending from the meatus to the site of the previous anastomosis at the penoscrotal junction...
October 26, 2017: Urology
https://www.readbyqxmd.com/read/29064176/calciphylaxis-after-parathyroidectomy
#5
Sathish Karmegam, Anupkumar Shetty
A 60-year-old African American man with end stage renal disease on hemodialysis (HD) for the past 2.5 years developed severe hyperparathyroidism. Other past medical history included atrial fibrillation, type II diabetes mellitus, hypertension, gout, pericardial effusion needing pericardial window, deep vein thrombosis, mitral insufficiency, and cardiomyopathy with implantable cardioversion device placement. His parathyroid hormone (PTH) level peaked at 4,191 pg/mL despite being on cinacalcet, sevelamer, and paricalcitol...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29053546/histopathology-of-calciphylaxis-cohort-study-with-clinical-correlations
#6
Tiffany Y Chen, Julia S Lehman, Lawrence E Gibson, Christine M Lohse, Rokea A El-Azhary
Calciphylaxis is a rare, painful, and life-threatening condition with a high mortality rate. Although the etiology of calciphylaxis is not well understood, it has been proposed that calcium deposition within and around subcutaneous vessels restricts blood flow chronically, thereby predisposing the patient to acute pannicular and dermal thrombosis. Given increasing recognition of the role of hypercoagulability in calciphylaxis, this retrospective cohort study sought to evaluate the presence of thromboses and dermal angioplasia in calciphylaxis...
November 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29043146/calciphylaxis-in-a-nondialysis-patient-treated-with-sodium-thiosulfate-and-high-dose-of-oxygen
#7
Anawin Sanguankeo, Natanong Thamcharoen, Sikarin Upala
BACKGROUND: Calciphylaxis in a nondialysis patient is a rare condition and is characterized by calcific deposition in tissue. We present a case of calciphylaxis in a nondialysis patient who was diagnosed by clinical presentation and skin biopsy and was treated with sodium thiosulfate with improvement of skin lesions. CASE: A 43-year-old female with type 2 diabetes and atrial fibrillation taking oral anticoagulation medication presented with reddish drainage from the right buttock...
2017: Clin Nephrol Case Stud
https://www.readbyqxmd.com/read/29016409/anterior-ischemic-optic-neuropathy-due-to-calciphylaxis
#8
Magne S Sivertsen, Erik H Strøm, Kim M A Endre, Øystein K Jørstad
A 72-year-old woman experienced anterior ischemic optic neuropathy in her left eye. The funduscopic and fluorescein angiographic findings were strongly suggestive of giant cell arteritis. Temporal artery biopsy revealed extensive calcification in the vessel wall consistent with calciphylaxis. This unusual disorder should be considered in the differential diagnosis of anterior ischemic optic neuropathy, particularly the arteritic form.
October 6, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28976876/parathyroidectomy-in-hyperparathyroidism-associated-calciphylaxis-in-end-stage-renal-disease-should-be-prompt-and-radical-a-case-report-with-two-original-therapeutic-modifications-and-successful-outcome
#9
Sylvie Dusilová Sulková, Jiří Horáček, Eva Vykoukalová, Roman Šafránek, Alena Malá, Vladimír Palička
We present a case of severe calciphylaxis in both thighs and calves in a patient with end-stage renal disease and advanced secondary hyperparathyroidism with successful outcome after modified therapeutic approach. The cause of calciphylaxis is multifactorial. In our case, not only severe hyperparathyroidism and mediocalcinosis, but also medication (warfarin, calcium and active vitamin D) was involved. Because the initial conservative therapy was not successful, we indicated parathyroidectomy. However, we were not able to localize parathyroid glands and we contraindicated bilateral neck exploration due to the patient's critical status...
2017: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/28932755/extraosseous-calcification-of-the-esophagus-clinicopathologic-correlates-of-esophageal-mucosal-calcinosis
#10
Ari Garber, Zubin Arora, Nicole Welch, James Lapinski, Carol A Burke
Esophageal mucosal calcinosis (EMC) is a rare cause of dysphagia with high morbidity. We present a patient who experienced melena and 3 months of solid and liquid dysphagia along with bilateral lower extremity pain, erythema, and edema later determined to be calcific uremic arteriolopathy (CUA), or calciphylaxis. An esophagogastroduodenoscopy revealed nodularity and linear ulcerations in the upper third of the esophagus. Histology showed active inflammation and ulceration with small foci of subepithelial and intraepithelial calcification consistent with EMC...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28923584/seeing-the-difference-painless-progressive-vision-loss-in-a-vasculopath
#11
Jenny L Lauschke, Katherine Masselos, Jennifer Sandbach, Clare L Fraser
A 78-year-old Caucasian man with significant vascular disease reported sudden onset of worsened vision during a routine wound-care appointment for non-healing necrotic leg ulcers. He described painless blurring of vision with grey scotomas in his RE, his only well-seeing eye, following trauma to the LE as a child. He presented with retinal ischemia, a cotton-wool spot and optic nerve swelling. Temporal artery biopsy showed myxoid degeneration and extensive calcium deposition which also was shown on imaging throughout his carotid and vertebral arterial system, the clinical picture of calciphylaxis...
September 15, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28880752/evaluation-of-osteopontin-expression-in-chronic-wounds-a-potential-prognostic-and-therapeutic-biomarker
#12
S Chimento, V Billero, L Cavallin, M Romanelli, M Nadji, P Romanelli
OBJECTIVE: Osteopontin (OPN) is abundantly expressed during tissue repair, acting as a powerful chemokine that recruits inflammatory cells such as neutrophils, macrophages, and Langerhans cells. The role of OPN in chronic wounds has not been explored. In this study, we assess the expression levels of OPN in chronic wounds to assess its potential contribution to the exacerbated inflammation seen in chronic ulcers, which is thought to contribute to poor healing. METHODS: This retrospective study included archived biopsies of chronic wounds from several aetiologies...
September 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28872557/sodium-thiosulfate-in-the-treatment-of-lung-and-breast-calciphylaxis-ct-and-bone-scintigraphy-findings
#13
Guohua Shen, Rui Huang, Bin Liu, Anren Kuang
A 19-year-old woman, with normal kidney function, was diagnosed as having visceral calciphylaxis, especially diffuse breast and lung calcification. The calcification findings were clearly shown on CT, and bone scintigraphy revealed diffuse uptake in the thoracic area. Although there was no standard therapeutic approach for this clinical setting, the patient received empiric therapy with sodium thiosulfate. After 5 months of consecutive therapy, the calcification condition had a striking regression.
September 1, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28869660/pseudoxanthoma-elasticum-like-changes-in-nonuremic-calciphylaxis-case-series-and-brief-review-of-a-helpful-diagnostic-clue
#14
Rajiv K Nathoo, Jennifer N Harb, Jena Auerbach, Ruifeng Guo, Vladimir Vincek, Kiran Motaparthi
Calciphylaxis is a rare syndrome of vascular calcification with thrombosis that occurs most often in patients with end-stage renal disease, and it frequently portends a guarded prognosis. Rarely, nonuremic calciphylaxis (NUC) may occur; in this context, a strongly supportive histology is crucial in establishing the diagnosis. Herein, we describe 2 cases of NUC associated with pseudoxanthoma elasticum-like changes, identified in both initial nondiagnostic and subsequent diagnostic biopsy specimens. This unusual but helpful histologic finding may support the early diagnosis and treatment of a potentially life-threatening disease in the context of subtle histopathologic vascular changes or in the absence of classic clinical or laboratory findings...
September 4, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28856671/direct-oral-anticoagulant-medications-in-calciphylaxis
#15
Brian J King, Rokea A El-Azhary, Marian T McEvoy, Raymond C Shields, Robert D McBane, James T McCarthy, Mark D P Davis
BACKGROUND: Recent studies suggest that calciphylaxis is a thrombotic condition in which arteriolar thrombosis leads to painful skin infarcts and consequent morbidity and mortality. Paradoxically, warfarin is implicated as a risk factor for calciphylaxis. Our objective is to report the use of oral direct thrombin and factor Xa inhibitors (termed direct oral anticoagulants [DOACs]) in patients with calciphylaxis. METHODS: We retrospectively reviewed records of 16 patients with calciphylaxis who received concomitant administration of novel anticoagulants...
October 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28852578/calciphylaxis-of-the-postmenopausal-female-breast-an-uncommonly-encountered-mimic-of-carcinoma
#16
Aaron G Novotny, Ashley B Simpson, Melinda A Kral, Benjamin C Calhoun, Amy E Cocco, Steven D Billings, Susan K Miller, Paulette L Lebda, Charles D Sturgis
Calciphylaxis is a serious medical condition that is typically associated with end-stage renal disease and presents as the sequelae of calcifications in arterioles with subsequent ischemia of affected tissues. Classically, calciphylaxis produces ulcerated and necrotic skin lesions. These may be biopsied to aid in confirmation of the diagnosis. Herein we report a case of a large necrotic breast lesion in the clinical setting of calciphylaxis, and we emphasize that a multidisciplinary approach to diagnosis and management is important to avoid unnecessary oncological resection...
2017: Case Reports in Pathology
https://www.readbyqxmd.com/read/28845953/vasculopathies-cutaneous-necrosis-and-emergency-in-dermatology
#17
Constanza Martinez-Mera, Javier Fraga, Tania M Capusan, Maria Herrero-Moyano, Almudena Godoy-Trapero, Yosmar Gonzales Perez, Mar Llamas-Velasco
Most emergencies in dermatology comprise a variety of entities with a usually benign course. However, vasculopathies and vasculitis are not common, but they could represent respectively 1.9% and 4.4% of these entities according to some studies of Emergency Dermatology Department. They become an important disease which has to be identified early to establish appropriate management and treatment. Some of them are well known, such as the leukocitoclastic vasculitis, Schölein-Henoch, panarteritis nodosa, antineutrophil cytoplasmic antibody associated vasculitis, giant cell arteritis, cryoglobulinemic vasculitis and antiphospholipid syndrome...
December 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28825580/-calciphylaxis
#18
Nicolás Raimondi, Jorge J Del Vecchio, Mauricio Ghioldi, Emanuel Uzair
Calciphylaxis is vasculopathy characterized by ischemia and painful skin necrosis due to calcification and intimal fibroplasia of thrombosis of the panicular arterioles. It most frequently compromises patients with terminal chronic renal failure and has a high mortality rate. Biopsy of skin lesions is used as a diagnostic method. No specific laboratory findings have been recorded. Skin lesions usually begin in the extremities like a painful purplish mottling similar to "livedo reticularis". The natural evolution is to ulcers and bedsores...
2017: Medicina
https://www.readbyqxmd.com/read/28781873/calciphylaxis-with-extensive-arterial-calcification
#19
Syed Irfan Qadri, Abhilash Koratala
Calciphylaxis is a clinical syndrome of arteriolar calcification with resultant tissue necrosis, most commonly seen in patients with end-stage renal disease (ESRD) on dialysis. This condition carries a high mortality rate mainly due to infection. Helpful interventions include adequate dialytic therapy, medical management of hyperparathyroidism, hyperphosphatemia, and intravenous sodium thiosulfate therapy.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28779847/efficacy-of-intralesional-sodium-thiosulfate-injections-for-disabling-tumoral-calcinosis-two-cases
#20
J Goossens, M Courbebaisse, E Caudron, C Bahans, V Vacquerie, J Melchior, P Vergne Salle, C Moesch, M Daudon, V Frocht, P Richette, Hang-Korng Ea, V Guigonis
INTRODUCTION: Tumoral calcinosis (TC) is a difficult-to-treat complication that can occur during several diseases such as dermatomyositis or genetic hyperphosphatemia. It is a painful and disabling condition that can lead to local complications including joint mobility reduction, cutaneous ulceration and superinfection. For the largest lesions, the treatment relies essentially on surgery. Intravenous sodium thiosulfate (STS) is efficient to treat calciphylaxis in patients undergoing hemodialysis...
June 17, 2017: Seminars in Arthritis and Rheumatism
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