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.