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CASE REPORT
Non-uraemic calciphylaxis (NUC) postliver transplantation
  1. Simona Frunza-Stefan1,
  2. Silpa Poola-Kella2,
  3. Kristi Silver1
  1. 1Medicine; Endocrinology, Diabetes and Nutrition, University of Maryland Medical Center, Baltimore, Maryland, USA
  2. 2Privia Medical Group, Fairfax, Virginia, USA
  1. Correspondence to Dr Simona Frunza-Stefan, simonastefan{at}gmail.com

Summary

Calciphylaxis is a rare and life-threatening disease characterized by cutaneous arteriolar stenosis and vascular thrombosis leading to skin ischaemia and necrosis. While calciphylaxis occurs mostly in patients with end-stage renal disease, the disorder has been described in patients with normal renal function, namely non-uraemic calciphylaxis (NUC). A 41-year-old African-American woman presented with a painful ulcerative rash on her thighs and right buttock 2 months after undergoing an orthotopic liver transplantation. She underwent debridement of the lesions and an excisional biopsy of one of the lesions, which revealed calciphylaxis. She was treated with sodium thiosulfate, cinacalcet and hyperbaric oxygen with complete resolution of the lesions 4–5 months after presentation. While she was treated with a course of high-dose glucocorticoids after the transplant, she did not have other risk factors for calciphylaxis. NUC should be considered in the differential diagnosis of necrotic skin lesions in postliver transplant patients.

  • liver disease
  • dermatology

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Footnotes

  • Contributors SF-S: contributed to the conception and design of the work as well as acquisition of data; major contributor in writing/ drafting the manuscript; and gave final approval of the version to be published. SP-K: contibuted to publication by conception; acquisition of data and its interpretation; discussed planning; and approved the final vision to be published. KS: contributed by discussing the conception and design; conducted the work; revised it critically for important intellectual content; and approved the final version to be published. All authors agreed to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have no financial disclosures.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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