| Abstract [eng] |
Objective. To review the clinical case of calciphylaxis in a patient with end-stage renal disease and to discuss the risk factors, diagnosis, treatment options and prognosis based on the publications of recent years. Materials. Vilnius University Hospital Santaros Clinics‘ patient‘s history was used for the clinical case report and studies from the international medicine database published no longer than 13 years ago. Methods. Analysis and comparison of a 24-year-old patient with end-stage renal disease and calciphylaxis complaints, medical and life history, objective examination, laboratory tests, based on the latest publications and treatment recommendations. Results and conclusions. Calciphylaxis is a rare and life-threatening disease that usually presents with painful skin lesions that can progress to dermal necrosis. This pathology is most commonly experienced by patients with end-stage renal disease and is suspected and determined by evaluation of risk factors and typical clinical signs. The clinical case discussed in this work illustrates the classical clinical manifestation of calciphylaxis, but the rarest localization of the lesion. The diagnosis is finally confirmed by skin biopsy and histology of the material, which usually shows the calcification of the medial layer of the arterioles. Some medicines can provoke the development of calciphylaxis, so if the patient have signs of calciphylaxis, the list of medicines he is taking should be carefully examined. Treatment of calciphylaxis is complex and the prognosis of the disease is extremely poor due to the worsen quality of life and the high risk of death in the first year after diagnosis. Therefore, it is necessary to draw the attention of patients and clinicians to this pathology, as knowledge about it is still lacking, faced with difficult differential diagnosis, extremely delayed path to the accurate final diagnosis. To further assess the risk of calciphylaxis, it is recommended to evaluate the dynamics of vascular and tissue calcification in patients with end-stage renal disease. There is also a lack of consistent and comprehensive treatment research, the small size of the studies makes it difficult to develop standardized guidelines for the care of patients with calciphylaxis. Keywords: end-stage renal disease, chronic kidney disease mineral and bone disorder, calcification, calcific uremic arteriolopathy, calciphylaxis, sodium thiosulphate. |
