Calciphylaxis in a renal transplant patient

Alvaro March-Rodriguez, Rebeca Alcalá, Ramon M Pujol

 Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain

Correspondence Address:
Alvaro March-Rodriguez
Department of Dermatology, Hospital del Mar, Passeig Marítim, 25-29, 08003 Barcelona
Spain

A 72-year-old woman presented with a 3-month history of painful skin ulcers on both legs [Figure - 1]. She had a history of renal transplant following polycystic kidney disease. Physical examination revealed extensive ulcers on pretibial areas surrounded by retiform purpura. Laboratory studies showed an impaired glomerular filtration rate (15 mL/min/1.73 m²). Serum calcium and phosphate levels were found to be normal but parathormone levels were elevated. Skin biopsy revealed calcification within the media of medium-sized arterioles in the dermis, that confirmed the diagnosis of calciphylaxis. After the diagnosis, the patient was put on hemodialysis and intravenous sodium thiosulfate, but died in a few weeks due to respiratory infection.

Figure 1: Close-up of extensive ulcer on left leg

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Conflicts of interest

There are no conflicts of interest.