A Case of Calciphylaxis
Nejra Prohic1,2 , Nejra Mlaco-Vrazalic1 , Svjetlana Radovic3 , Akif Mlaco 4,5 , Dragan Totic 2,6 , Belma Paralija 5,7
1 Department of Internal Medicine, General Hospital “Prim. Dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
2 Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
3 Department for Pathology, General Hospital “Prim. Dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
4 Department of Angiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
5 Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
6 Department for Vascular Medicine, General Hospital “Prim. Dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
7 Clinic for Lung Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Corresponding Author: Nejra Prohic MD, MSc. Department of Internal Medicine, General Hospital “Prim. Dr Abdulah Nakas”. E-mail: nora.nejra@gmail.com. Phone: +387 33 285 100; ORCID ID: 0000-0001-6789-1096
Cite this article: rohic N, Mlaco-Vrazalic N, Radovic S, Mlaco A, Totic D, Paralija B. A Case of Calciphylaxis – Case Report. Sar Med J. 2024; 1(2): Online ahead of print. 
10.70119/0013-24
Pages: 118-122 / Published online: 06 November 2024
Original submission: 23 June 2024; Revised submission: 15 September 2024; Accepted: 21 October 2024
Abstract
Introduction: Calciphylaxis (calcifi c uremic arteriolopathy), is a condition primarily observed in patients with end-stage renal disease (ESRD).
Aim: To increase clinical awareness of calciphylaxis and to consider it a differential diagnosis in the presence of atypical skin nodules or ulcers occurring in patients with chronic kidney disease (CKD), especially in patients on hemodialysis and non-hemodialysis patients with the background of diabetes mellitus and secondary hyperparathyroidism.
Case Report: We present the case of a 77-year-old woman with CKD and diabetes mellitus as well as severely painful, firm, indurated plaques on the lower extremities. The plaques progressed to involve larger areas with associated local ulceration and necrosis. Laboratory testing revealed hyperparathyroidism and incisional skin biopsy confirmed calciphylaxis.
Conclusion: Each single CKD patient with diabetes mellitus and signs of secondary hyperparathyroidism with extremely painful ischemic cutaneous lesions or painful subcutaneous nodules without skin changes, although at times, pain may precede the development of the lesions, is a candidate for skin biopsy. Calciphylaxis is a rare but serious kidney complication.
Keywords: alciphylaxis, chronic kidney disease, prognosis, treatment.
