RT Journal Article SR Electronic T1 Removing the problem: parathyroidectomy for calciphylaxis JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e226696 DO 10.1136/bcr-2018-226696 VO 11 IS 1 A1 Mohamed Hassanein A1 Heather Laird-Fick A1 Richa Tikaria A1 Saleh Aldasouqi YR 2018 UL http://casereports.bmj.com/content/11/1/e226696.abstract AB Calcific uremic arteriolopathy (CUA), widely known as calciphylaxis, is a rare and lethal disease that usually affects patients with end-stage renal disease. It is characterised by widespread vascular calcification leading to tissue ischaemia and necrosis and formation of characteristic skin lesions with black eschar. Treatment options include sodium thiosulfate, cinacalcet, phosphate binders and in resistant cases, parathyroidectomy. We report a case of recurrent, treatment-resistant CUA successfully treated with parathyroidectomy. Her postoperative course was complicated by hungry bone syndrome and worsening of her wounds before they completely healed. We then discuss the morbidity of CUA, including the controversy around the use of parathyroidectomy and risk of aggressive management of hungry bone syndrome.