Calciphylaxis Masquerading as Warfarin Induced Skin Necrosis

Nagadarshini Ramagiri Vinod¹, Hassan Tahir^1, , Saad Ullah¹, Hassan Zeb¹ and Arslan Ahmed²

¹Temple University/Conemaugh Memorial Hospital Johnstown, PA, USA

²Social Security Hospital, Lahore, Pakistan

Cite this paper

Nagadarshini Ramagiri Vinod, Hassan Tahir, Saad Ullah, Hassan Zeb and Arslan Ahmed. Calciphylaxis Masquerading as Warfarin Induced Skin Necrosis. American Journal of Medical Case Reports. 2017; 5(5):113-115. doi: 10.12691/AJMCR-5-5-2

Abstract

Calciphylaxis is rare complication of end stage renal disease on hemodialysis. Calciphylaxis closely mimics warfarin induced skin necrosis in dialysis patients who are being started on coumadin thus posing a diagnostic challenge. Skin biopsy may be required in such cases to confirm the diagnosis.

Keywords

warfarin skin necrosis, caliphylaxis

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Rapid resolution of calciphylaxis with intravenous sodium thiosulfate and continuous venovenous haemofiltration using low calcium replacement fluid:case report G Guerra, RC Shah, EA Ross - Nephrology Dialysis Transplantation, 2005 - ERA-EDTA.
[2]	Medline ® Abstract for Reference 32 of 'Calciphylaxis (calcific uremic arteriolopathy)'-Nigwekar SU, Solid CA, Ankers E, Malhotra R, Eggert W, Turchin A, Thadhani RI, Herzog CA.
[3]	Risk factors and mortality associated with calciphylaxis in end-stage renal disease. Mazhar AR, Johnson RJ, Gillen D, Stivelman JC, Ryan MJ, Davis CL, Stehman-Breen CO.
[4]	Cutaneous necrosis from calcific uremic arteriolopathy. Coates T, Kirkland GS, Dymock RB, Murphy BF, Brealey JK, Mathew TH, Disney AP.
[5]	Selye H, Gentile G, Pioreschi P: Cutaneous molt induced by calciphylaxis in the rat. Science134: 1876-1877,1961.
[6]	Budisavljevic MN, Cheek D, Ploth DW: Calciphylaxis in chronic renal failure.J Am Soc Nephrol7: 978-982, 1996.
[7]	Wallin R, Cain D, Sane DC: Matrix Gla protein synthesis and gamma-carboxylation in the aortic vessel wall and proliferating vascular smooth muscle cells: A cell system which resembles the system in bone cells. Thromb Haemost82 :1764-1767, 1999.
[8]	Brandenburg VM, Kramann R, Specht P, Ketteler M. Calciphylaxis in CKD and beyond. Nephrol Dial Transplant. 2012; 27: 1314-1318.
[9]	Hayden MR, Goldsmith D, Sowers JR, Khanna R. Calciphylaxis: calcific uremic arteriolopathy and the emerging role of sodium thiosulfate. Int Urol Nephrol. 2008; 40: 443-451.
[10]	Ng T, Tillyer ML. Warfarin-induced skin necrosis associated with Factor V Leiden and Protein S deficiency. Clin Lab Haematol 2001; 23: 261-4.
[11]	Comp PC, Elrod JP, Karzenski S. Warfarin-induced skin necrosis. Semin Thromb Hemost 1990; 16(4): 293-8.
[12]	Yatzidis H (1985) Successful sodium thiosulphate treatment for recurrent calcium urolithiasis. Clin Nephrol 23(2): 63-67.
[13]	Cicone JS, Petronis JB, Embert CD, Spector DA (2004) Successful treatment of calciphylaxis with intravenous sodium thiosulfate. Am J Kidney Dis 43(6): 1104-1108.
[14]	Geurra G, Shah RC, Ross AE (2005) Rapid resolution of calciphylaxis with intravenous sodium thiosulfate and continuous venovenous haemofiltration using low calcium replacement fluid: case report. Nephrol Dial Transplant 20(6): 1260-1262.