A Rare and Painful Byproduct of ESRD

​BY HABIR MANDAIR; KEYUR KURANI; &KHALID MALIK, MDA 62-year-old obese woman with end-stage renal disease (ESRD) who was on hemodialysis, hypertension, diabetes mellitus, and chronically elevated serum calcium levels presented to the ED with altered mental status. Nursing home staff stated that she was unable to answer questions coherently and seemed confused.Her vitals were within normal limits except for a body temperature of 99.9°F. Several necrotic lesions of various sizes were found on her left and right buttocks and the medial aspects of both thighs. The patient also had severe necrosis of the third finger on her left hand and the second on her right hand. Calciphylaxis was suspected because of her history and the unique characteristics of the lesions.Lab results showed a serum calcium level of 13.6 mg/dL, a PTH of 102.2 pg/mL, and elevated vitamin D levels. The patient was admitted and treated by wound care, nephrology, and endocrinology. Medications and dialysis regimen were also adjusted to achieve adequate serum calcium control.Recognition and Risk FactorsCalcific uremic arteriopathy (CUA), the more accurate name for calciphylaxis, is a rare disorder resulting from impaired calcium and phosphate homeostasis most often found in ESRD patients. Metastatic calcification of blood vessels isn't uncommon in ESRD patients, but CUA is distinctly different because it selectively targets dermal and subcutaneous arterioles in areas of high adiposity, as seen in the thi...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Occupational therapy Professional topics Resilience Science in practice Source Type: blogs
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Source: Trends in Molecular Medicine - Category: Molecular Biology Authors: Tags: Trends Mol Med Source Type: research
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Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
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Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
Authors: Kato M, Sugimoto A, Atsumi T Abstract INTRODUCTION: Pulmonary arterial hypertension (PAH), also referred to as group 1 pulmonary hypertension, occurs either primarily or in association with other diseases such as connective tissue diseases (CTD). Of CTD, systemic sclerosis (SSc), systemic lupus erythematosus and mixed connective tissue disease are commonly accompanied with PAH. It is of note that SSc-PAH is associated with distinctive histopathology, an unfavorable outcome, and a blunted responsiveness to modern PAH therapies. AREAS COVERED: The data in articles published until May 2020 in peer-reviewe...
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research
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Source: Chemosphere - Category: Chemistry Authors: Tags: Chemosphere Source Type: research
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