Extracutaneous Manifestations of Calciphylaxis: Ogilvie’s Syndrome With Perforation

2020 ◽  
Vol 86 (5) ◽  
pp. 546-548
Author(s):  
Thomas A. Mitchell ◽  
Zachary S. Hoffer ◽  
Leopoldo C. Cancio
Keyword(s):  
Surgical Intervention ◽  
Rare Entity ◽  
Colonic Ischemia ◽  
Ogilvie's Syndrome ◽  
Cutaneous Lesions ◽  
Total Abdominal Colectomy ◽  
Ogilvie’S Syndrome ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage

Calciphylaxis or calcific uremic arteriolopathy is a rare entity associated with the end-stage renal disease that presents with necrotic cutaneous lesions that may require surgical management. Extracutaneous manifestations of calciphylaxis including visceral ischemia have been reported; however, surgical intervention for colonic ischemia has only been reported twice. We report a 49-year-old male with calciphylaxis who subsequently developed Ogilvie’s syndrome complicated by perforation requiring total abdominal colectomy with end ileostomy. Surgeons treating this disease should have a heightened awareness of the extracutaneous sequelae of calciphylaxis.

scholarly journals Removing the problem: parathyroidectomy for calciphylaxis

2018 ◽  
Vol 11 (1) ◽  
pp. e226696 ◽  
Author(s):  
Mohamed Hassanein ◽  
Heather Laird-Fick ◽  
Richa Tikaria ◽  
Saleh Aldasouqi
Keyword(s):  
Treatment Options ◽  
Sodium Thiosulfate ◽  
Skin Lesions ◽  
Phosphate Binders ◽  
Treatment Resistant ◽  
Hungry Bone Syndrome ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Hungry Bone

Calcific uremic arteriolopathy (CUA), widely known as calciphylaxis, is a rare and lethal disease that usually affects patients with end-stage renal disease. It is characterised by widespread vascular calcification leading to tissue ischaemia and necrosis and formation of characteristic skin lesions with black eschar. Treatment options include sodium thiosulfate, cinacalcet, phosphate binders and in resistant cases, parathyroidectomy. We report a case of recurrent, treatment-resistant CUA successfully treated with parathyroidectomy. Her postoperative course was complicated by hungry bone syndrome and worsening of her wounds before they completely healed. We then discuss the morbidity of CUA, including the controversy around the use of parathyroidectomy and risk of aggressive management of hungry bone syndrome.

Calcific Uremic Arteriolopathy

2013 ◽  
Vol 24 (3) ◽  
pp. 285-300
Author(s):  
Kimberly G. Anderson
Keyword(s):  
Early Recognition ◽  
Renal Dialysis ◽  
Optimal Level ◽  
Health Care Team ◽  
Team Approach ◽  
Clear Understanding ◽  
Treatment Plans ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage

Calcific uremic arteriolopathy is a little understood diagnosis of increasing prevalence seen predominantly in patients with chronic kidney disease, particularly those who are approaching end-stage renal disease, who are undergoing renal dialysis, and who have secondary hyperparathyroidism. Calcific uremic arteriolopathy affects women more frequently than men, at a ratio of 3:1, and the median age at diagnosis is 48 years. A clear understanding of the pathogenesis and definitive plans of care are lacking. Nurses should be familiar with the clinical picture of calcific uremic arteriolopathy. Early recognition is important to develop optimal treatment plans and to limit progression of this rare but often fatal disease. Nurses have a pivotal role in maintaining the patient’s comfort and dignity, while setting realistic goals of care. Calcific uremic arteriolopathy remains a rare and complex clinical condition that requires a multidisciplinary health care team approach to provide the optimal level of care. Nurses have an essential role in the care of patients with the diagnosis of calcific uremic arteriolopathy.

Aggressive Surgical Intervention in End-Stage Renal Disease Patients with Spinal Epidural Abscess

Renal Failure ◽  
2011 ◽  
Vol 33 (6) ◽  
pp. 582-586 ◽  
Author(s):  
Mei-Yi Wu ◽  
Tsai-Sheng Fu ◽  
Chih-Hsiang Chang ◽  
Hsiang-Hao Hsu ◽  
Ming-Yang Chang ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Epidural Abscess ◽  
Surgical Intervention ◽  
Spinal Epidural Abscess ◽  
Stage Renal Disease ◽  
End Stage ◽  
Spinal Epidural

scholarly journals Calciphylaxis in a Patient on Home Hemodialysis

2020 ◽  
Vol 8 ◽  
pp. 232470962092271 ◽  
Author(s):  
Sreedhar Adapa ◽  
Srikanth Naramala ◽  
Vijay Gayam ◽  
Narayana Murty Koduri ◽  
Subba Rao Daggubati ◽  
...  
Keyword(s):  
Wound Care ◽  
Sodium Thiosulfate ◽  
Skin Lesions ◽  
Current Treatment ◽  
Home Hemodialysis ◽  
Calcium Phosphorus ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Subcutaneous Adipose

Calciphylaxis is a rare and severe complication characterized by calcification of arterioles and capillaries in the dermis and subcutaneous adipose tissue that leads to ischemia, necrosis, and painful skin lesions in patients with end-stage renal disease (ESRD). It is also known as calcific uremic arteriolopathy. Calciphylaxis occurs most commonly with the ESRD with skin ulceration as a predominant presenting feature. Calcium-phosphorus dysregulation in dialysis patients are traditionally considered as a risk factor for the development of calciphylaxis. The involvement of an integrated interdisciplinary and multifaceted approach is key to the success of the calciphylaxis treatment. We present a case of a 51-year-old female with ESRD on home hemodialysis who developed calciphylaxis, which was successfully managed with increasing dialysis prescription, diligent wound care, and sodium thiosulfate infusion. Management of calciphylaxis in a patient receiving home hemodialysis has never been reported as per the review of the literature. Calciphylaxis is a sporadic disease, frequently encountered in the patients undergoing hemodialysis and carries a very grave prognosis. Current treatment is rarely effective, so preventive strategies play an important role by modifying the risk factors that promote the development of calciphylaxis.

Laparoscopic Surgery in Patients on Peritoneal Dialysis: A Review of the Literature

2017 ◽  
Vol 24 (4) ◽  
pp. 397-401 ◽  
Author(s):  
Giulio Mari ◽  
Renzo Scanziani ◽  
Sara Auricchio ◽  
Jacopo Crippa ◽  
Dario Maggioni
Keyword(s):  
Peritoneal Dialysis ◽  
Laparoscopic Surgery ◽  
End Stage Renal Disease ◽  
Open Surgery ◽  
Surgical Intervention ◽  
Case Series ◽  
Laparoscopic Technique ◽  
Review Of The Literature ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis (PD) is an effective renal replacement therapy for the treatment of end-stage renal disease. Patients on PD undergoing abdominal open surgery often fail to resume PD. Laparoscopic surgery has recently become a serious alternative to open surgery in patients on PD to treat different abdominal pathologies. However, only a few studies have reported successful procedures without Tenckhoff catheter removal. The aim of this review is to describe how a laparoscopic technique can allow PD patients to deal with abdominal surgery without shifting to hemodialysis. Only 50 cases of laparoscopic surgical intervention in PD patients have been published to our knowledge. These case series largely concern laparoscopic cholecystectomies, appendectomies, nephrectomies, colectomies, and bariatric procedures. The reported cases show how laparoscopic surgery can be accepted as a valid option for several abdominal surgical procedures in patients on PD with good outcomes and early resumption of PD.

scholarly journals Surgical Management of Calciphylaxis Associated with Primary Hyperparathyroidism: A Case Report and Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Jennifer Bishop ◽  
Eric Brown ◽  
Augusto Podesta ◽  
Cathrine Troy ◽  
Xiang (Eric) Dong
Keyword(s):  
Primary Hyperparathyroidism ◽  
English Literature ◽  
High Rate ◽  
Medical Problems ◽  
Extensive Calcification ◽  
Calcific Uremic Arteriolopathy ◽  
Mediastinal Parathyroid Adenoma ◽  
Stage Renal Disease ◽  
End Stage ◽  
Mediastinal Parathyroid

Calciphylaxis, or calcific uremic arteriolopathy, commonly affects people with end-stage renal disease and carries with it a high rate of morbidity and mortality. Here, we present the unusual case of a 56-year-old woman, with extensive medical problems, who developed calciphylaxis in the presence of primary hyperparathyroidism. Our patient initially presented with bilateral, exquisitely tender thigh lesions. The diagnosis of calciphylaxis was rendered histologically by extensive calcification of the subcutaneous blood vessels. Subsequent parathyroidectomy identified the presence of a hyperactive mediastinal parathyroid adenoma, weighing 0.62 grams. Postoperatively, the patient had normalization of hypercalcemia and parathyroid hormone levels, with subsequent healing of her thigh wounds. Currently, there have been sixteen cases described in the English literature, with only nine being offered a potentially therapeutic parathyroidectomy. It is contingent upon the vigilant physician to diagnose and properly manage this difficult yet treatable condition.

scholarly journals Patterns of vascular calcification in patients with end-stage renal disease and calcific uremic arteriolopathy

2017 ◽  
Vol 5 (12) ◽  
pp. 2143-2145 ◽  
Author(s):  
Abhilash Koratala ◽  
Muhannad Leghrouz ◽  
Melinda H. Phillips ◽  
Vikrampal Bhatti
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Penile Calciphylaxis in End Stage Renal Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Vincenzo Barbera ◽  
Luca Di Lullo ◽  
Antonio Gorini ◽  
Giovanni Otranto ◽  
Fulvio Floccari ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Peritoneal Dialysis Patient ◽  
Mortality Rates ◽  
Hemodialysis Patients ◽  
Efficacy And Safety ◽  
Therapeutic Approaches ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage

Calciphylaxis, better described as “Calcific uremic arteriolopathy” (CUA), involves about 1–4% of hemodialysis patients all around the world with high mortality rates. We describe a rare clinical case of CUA in peritoneal dialysis patient associated with urological disease. Penile calciphylaxis represents rare clinical complication, and an early diagnosis and multidisciplinary approach are requested. Pathogenesis is still unclear, and therapeutic approaches need more long-term clinical trials to test their efficacy and safety.

scholarly journals Giant peritoneal loose body in a patient with end-stage renal disease

2018 ◽  
Vol 6 ◽  
pp. 2050313X1877093
Author(s):  
Nadejda Cojocari ◽  
Leonard David
Keyword(s):  
Computed Tomography ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Loose Body ◽  
Rare Entity ◽  
Computed Tomography Scan ◽  
Transplantation Surgery ◽  
Stage Renal Disease ◽  
End Stage ◽  
Tomography Scan

A 72-year-old male with end-stage renal disease underwent a computed tomography scan to assess renal function. An oval-shaped mass, 50 mm × 60 mm in size, was discovered incidentally in his recto-vesical pouch. Because it was suspected to be a teratoma, which could be an impediment for future renal transplantation, surgery was performed. It revealed a giant peritoneal loose body, a rare entity, that has not been reported before in patients with renal chronic insufficiency.

scholarly journals Role of Sodium Thiosulphate in Calciphylaxis

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Meshal Qaiser ◽  
◽  
Arora Kanwardeep ◽  
Keyword(s):  
Adverse Effect ◽  
Metabolic Acidosis ◽  
End Stage Renal Disease ◽  
Rare Condition ◽  
Sodium Thiosulphate ◽  
Calcific Uremic Arteriolopathy ◽  
Stage Renal Disease ◽  
End Stage

Calciphylaxis, also known as Calcific Uremic Arteriolopathy (CUA), is a rare condition often but not exclusively seen in end stage renal disease. Current literature recommends trial of Sodium Thiosulphate (STS) in all CUA patients. The long - term use of STS is limited by the adverse effect of Anion Gap Metabolic Acidosis (AGMA) which can be managed timely to maximize the benefits of STS.

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