BOF: 2.18
A 40-year-old female who has end stage renal failure and
is on renal replacement therapy presents with painful skin lesions that came
on suddenly and are progressing rapidly. She also gives a history of recent ,
sudden weight loss. On examination she has lesions on her thighs. The lesions
are star shaped, purpuric lesions with central ulceration. They are indurated
and extremely tender.
Biopsy of these lesions shows calcification of the media
of the small and medium sized vessels with intimal hyperplasia and fibrosis.
This is surrounded by a mixed inflammatory infiltrate.
In this patient which of the following forms of treatment
would be of no benefit?
a)
Judicious use of antibiotics
b)
Surgical debridement
c)
Hyperbaric oxygen
d)
Parathyroidectomy
e) Immunosuppression
Answer :
e)
The clinical features and biopsy features suggest the
patient has calciphylaxis. The
first four methods of treatment are of benefit in calciphylaxis.
Immunosuppression may be a trigger for this condition.
Calciphylaxis
