Calciphylaxis: A Pseudo-Vasculitis Syndrome

Abstract

To report a case of fatal calciphylaxis, an uncommon condition affecting patients with chronic renal disease and calcium metabolism abnormalities, that can mimic vasculitis. We reviewed the English literature using the Medline and Embase databases and keywords "calciphylaxis" and "calcific uremic arteriolopathy." A patient with end-stage renal disease and no known calcium metabolism abnormalities presented with intractable lower extremity ulcers and skin findings suggestive of small-vessel disease of the upper extremities. Biopsy of the lesions showed classic calciphylaxis without evidence of vasculitis. The patient died shortly after an above-the-knee amputation. Calciphylaxis needs to be considered in the differential diagnosis of vasculitis. Skin biopsy soon after presentation is imperative for diagnosis and to avoid potentially harmful treatments such as corticosteroids and immunosuppressive medications.