Case ReportCalciphylaxis precipitated by ultraviolet light in a patient with end-stage renal disease secondary to systemic lupus erythematosus
Section snippets
Case report
A 39-year-old woman with end-stage renal disease (ESRD) secondary to SLE presented in 1997 with a 2- to 3-week history of bilateral thigh pain.
In 1978, this patient first presented with encephalopathy, psychosis, and stroke syndrome. She had a prolonged hospitalization course (including 1 month in the intensive care unit), marked by an acute myocardial infarction and acute renal failure requiring renal replacement therapy. A renal biopsy was nondiagnostic. She received CAPD for 3 years, then
Discussion
Although the exact mechanism underlying the development of calciphylaxis remains to be clarified, the experimental work of Selye et al1, 2 has significantly contributed to the knowledge thus far. More recently, a review of nine patients with proximal calciphylaxis6 identified high body mass index, low serum albumin level, and white race as risk factors for calciphylaxis.
Our patient with ESRD and secondary hyperparathyroidism developed topical lesions associated with severe pain, hyperesthesia,
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Address reprint requests to Joanne M. Bargman, MD, Associate Professor of Medicine, University of Toronto, Staff Nephrologist, Toronto General Hospital, 200 Elizabeth St, 10EN-216, Toronto, Ontario, Canada M5G 2C4. E-mail: [email protected]