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A rapidly progressive case of Calciphylaxis

CR3 (29) - Vandal - Calciphylaxis
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Project Title: A rapidly progressive case of Calciphylaxis Authors: Carmen Vandal, MD; Stephen Cheung, DO (PGY2); Bradford Winslow, MD

Program: Swedish Family Medicine Residency

Abstract: Background: Calciphylaxis is a serious skin disorder that is characterized by calcification, fibrosis, and thrombus formation that results in skin necrosis. It is associated with significant morbidity and mortality and is most commonly seen in patients with end-stage renal disease. However, there are also documented cases in non-ESRD patients. Here we describe a patient with cirrhosis who presented with wounds and diagnosed with calciphylaxis. Case: A 37 year old female with cirrhosis presented with necrotic painful lesions on her trunk. Skin biopsies were taken but results did not provide a clear diagnosis and she was presumptively treated for a vasculitis. Multiple specialists were consulted including dermatology, plastic surgery, gastroenterology, rheumatology, infectious disease, hematology, nephrology, and pathology. A repeat biopsy was consistent with calciphylaxis. The patient’s condition progressed and she was transitioned to hospice. Conclusion: One of our main jobs as primary care physicians is to coordinate care. Given the complexity and seriousness of this case, it was very important for our team to coordinate care on a daily basis with specialists.

Learning Objectives: Participants will be able to… • demonstrate an understanding of calciphylaxis • consider a wide differential diagnosis when treating a patient that is not clinically improving • discuss the importance of coordinating care in the hospital

Category: Case Report

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