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Early onset calciphylaxis following acute kidney injury secondary to anti-glomerular basement membrane antibody disease
  1. Sheikh Raza Shahzad1,
  2. Faris Alfaris2,
  3. Mustafa Erdem Arslan3 and
  4. Swati Mehta2
  1. 1Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
  2. 2Nephrology and Hypertension, Albany Medical Center Hospital, Albany, New York, USA
  3. 3Pathology, Albany Medical Center Hospital, Albany, New York, USA
  1. Correspondence to Dr Sheikh Raza Shahzad; shahzas1{at}amc.edu

Abstract

Calciphylaxis is commonly associated with end-stage renal disease (ESRD) and renal transplant. We present a rare case of early onset calciphylaxis in a patient presenting with acute kidney injury (AKI) secondary to anti-glomerular basement membrane (anti-GBM) antibody disease. A 65-year-old obese Caucasian woman with type 2 diabetes mellitus and hypertension presented with a 1-month history of painless gross haematuria and worsening lower extremity oedema. Laboratory results indicated AKI and nephrotic-range proteinuria. Anti-glomerular antibodies were elevated. Renal biopsy revealed focal crescentic glomerulonephritis with linear capillary immunoglobulin G staining consistent with anti-GBM antibody disease. She was treated with haemodialysis, plasmapheresis, steroids, bumetanide and cyclophosphamide. Two months later, she developed necrotic lesions on bilateral thighs. Wound biopsy was consistent with calciphylaxis. This case highlights that calciphylaxis, usually seen in patients with chronic kidney disease or ESRD, can manifest in patients with AKI as well.

  • acute renal failure
  • dialysis
  • nephrotic syndrome
  • calcium and bone
  • proteinurea

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Footnotes

  • Twitter @MEArslanMD

  • Contributors SRS is a primary author of this case report who contributed to all the sections. FA contributed to the literature review. MEA is the pathologist on this case who provided the pathology slides with their interpretation.SM is the nephrology attending of the patient who contributed to every section.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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