Multiple sites of calciphylaxis in a patient with chronic renal failure

Abstract EN

Calciphylaxis has seldom been reported in patients with acute renal failure or in pre-dialysis patients.

It also has been reported at lower calcium phosphorous products and in patients with adynamic bone disease.

We report a pre-hemodialysis (HD) patient with acute renal failure and biopsy-proven calciphylaxis involving multiple cutaneous sites with calcification of the perineal area resulting in dry gangrene of the penis that necessitated a partial penectomy.

The patient had elevated serum calcium, phosphorous and parathyroid hormone level of 612 pg / mL.

The same patient suffered subsequently from a calcium embolus that occluded his left ophthalmic artery and resulted in left eye blindness.

Calciphylaxis is a devastating phenomenon and physicians should have a high clinical suspicion for it in HD patients as well as in patients with late stages of chronic kidney disease.