J Nephropathol. 2019;8(2): e20.
doi: 10.15171/jnp.2019.20
  Abstract View: 518
  PDF Download: 355

Case Report

Nonuremic calciphylaxis in a post renal transplant patient 

Maria Srour 1, Bahar Bastani 1 *

1 Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
*Corresponding author: Bahar Bastani, Email: Email: bahar.bastani@health.slu.edu

Abstract

Background: Calciphylaxis is a potentially fatal condition previously observed in patients with poor renal function. We present a case of atypical presentation in a patient with good renal function after transplantation.

Case Presentation: A-68-year old African American female with history of end-stage renal disease (ESRD) secondary to type II diabetes mellitus on hemodialysis for ten years, status post living related donor kidney transplant from her son three years prior to this presentation, parathyroidectomy, and atrial fibrillation on warfarin presented to our institution with progressively worsening, severely tender bilateral thigh lesions that were diagnosed as calciphylaxis. She was treated with sodium thiosulfate infusions for six months and continues to do well.

Conclusions: Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), has traditionally been associated with ESRD patients on maintenance dialysis, however several nonuremic cases of CUA have been reported in recent years. Multiple pathophysiologic mechanisms for CUA development have been proposed expanding the scope of known risk factors and possible triggers. CUA can be a life-threatening condition that is important for clinicians to recognize and treat as soon as possible.

Implication for health policy/practice/research/medical education:

Clinicians need to be aware that CUA can occur in patients with good renal function, such as post transplantation, when other risk factors such as obesity and warfarin treatment exist.

Please cite this paper as: Srour S, Bastani B. Nonuremic calciphylaxis in a post renal transplant patient. J Nephropathol. 2019;8(2):e20. DOI: 10.15171/jnp.2019.20.

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Submitted: 28 Oct 2018
Accepted: 03 Jan 2019
First published online: 29 Jan 2019
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