Calciphylaxis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Calciphylaxis is a rare and serious condition brought on by calcium accumulation in the small blood capillaries found in the skin and fat tissues.

Calciphylaxis can result in painful skin ulcers, blood clots, and potentially deadly infections. People who suffer from calciphylaxis usually have kidney transplants, dialysis users, or renal failure. There are other disorders besides nephropathy that can affect healthy people.

Causes Of Calciphylaxis

New research indicates that most people with calciphylaxis have abnormalities in blood clotting components, while the exact cause of the condition is unknown. The substances in the blood called blood-clotting factors help to stop bleeding. These abnormalities may result in small blood clots forming more frequently than they otherwise would.

In addition, calciphylaxis patients have an imbalance in their calcium metabolism. Blood clots eventually form in the arterioles, the smallest parts of the arteries, as a result of calcium deposits in those areas. Blood clots can deprive fat and skin tissues of nourishment and oxygen.

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Symptoms Of Calciphylaxis

Signs and symptoms of calciphylaxis include:

• Large purple net patterns on the skin
• Deep, excruciatingly painful pumps that ulcerate and leave open sores with a brown and black crust that never heals. Though they can appear anywhere else, they are typically found on skin with a high-fat content, including the stomach and thighs.
• Infections brought on by wounds that don't heal

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Risk Factors Of Calciphylaxis

Patients with end-stage renal failure account for the bulk of calciphylaxis cases. The following are some possible risk factors:

• Women's obesity
• Anomalies associated with blood coagulation factors
• Diabetes
• An imbalanced intake of calcium, phosphate, and aluminum caused by long-term dialysis and occasionally kidney transplantation
• Hyperparathyroidism is the overproduction of parathyroid hormone (PTH), which regulates the body's levels of calcium and phosphorus. Certain medications, such as corticosteroids, calcium-binding medicines, or warfarin (Coumadin, Jantoven).
• When the body retains substances like calcium and phosphorus that are normally eliminated in the urine, it can lead to uremia, a dangerous condition.

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Diagnosis Of Calciphylaxis

If you have calciphylaxis, your doctor will determine it by performing a physical examination, assessing your symptoms, and reviewing your medical history. Examinations could include:

• A skin biopsy: Your doctor may use a small sample of tissue from the affected skin area for analysis in order to diagnose calciphylaxis.
• Blood testing: Blood tests measure aluminum, urea nitrogen, creatinine, albumin, calcium, phosphorus, parathyroid hormone, anomalies in blood-clotting factors, and more to assist your doctor in assessing your kidney and liver function.
• Imaging-related studies: X-rays of the blood arteries can show the presence of vascular calcifications, or branch-like calcium deposits, which are commonly found in severe renal illnesses such as calciphylaxis.

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Treatment Of Calciphylaxis

Some of the various interventions used to treat calciphylaxis include the following:

• You will likely be prescribed an anticoagulant medication, such as apixaban, to help prevent blood clots and restore blood flow to wounded tissues.
• Hyperbaric oxygen therapy can enhance the body's capacity to deliver oxygen to wounded areas. As an alternative, your doctor may use a low-dose tissue plasminogen activator (TPA) to break up blood clots in the skin's microscopic blood vessels.
• Dialysis: Your doctor may change your dialysis prescription if you are getting renal dialysis, including the medications you take and the frequency of your sessions.
• Adjusting a medication regimen: Your doctor will examine your medications, rule out any chemicals like iron, corticosteroids, or warfarin that could induce calciphylaxis, and change the dosage of any supplements you are taking for calcium or vitamin D.
• Utilizing pharmaceuticals on prescription: A medication called sodium thiosulfate aids in lowering the buildup of calcium in the arterioles. Every week, usually during dialysis, three intravenous doses are given. Additionally, your doctor might recommend the medication cinacalcet (Sensipar), which helps balance parathyroid hormone (PTH). Taking additional drugs can help to improve the balance of calcium and phosphorus.
• Surgery: Surgical excision of all or part of the parathyroid glands may be recommended in situations where hyperparathyroidism, or excessive production of parathyroid hormone, results in abnormal calcium metabolism.
• For the sores to heal, debridement, or the surgical removal of some of the tissue destroyed by calciphylaxis, may be required. Other methods of tissue removal, like moist dressings, may be applicable in some situations. The use of antibiotics is one way to treat and prevent wound infection.
• You can be prescribed medication for wound care or pain relief after calciphylaxis.

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Complications Of Calciphylaxis

The following are calciphylaxis complications:

• Excruciating pain
• Large, deep sores that don't go away
• Blood infections
• Death,Usually caused by disease and organ failure

For the majority of individuals, calciphylaxis patients do not have much hope. Treatment and early detection are critical to the prevention of serious infections.

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