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혈액투석 중인 당뇨병성 신병증 환자에서 발생한 Calciphylaxis 1예
김권수,구자룡,김근호,박민숙,노정우,김형직,박혜림,채동완,손진희,전노원,한성우 대한신장학회 1997 Kidney Research and Clinical Practice Vol.16 No.2
Calciphylaxis is a rare but life-threatening complication in patients with end stage renal disease (ESRD). Clinical presentation consists of violaceous skin lesions that progress to nonhealing ulcers and gangrene. Secondary infection of skin lesions is common, often leading to sepsis and death. We report a case presenting in 16 months after maintenance hemodialysis for diabetic ESRD with painful violaceous skin discoloration on distal fingers of both hands and toes of left foot. X-ray of both hands and left foot showed vascular calcification along the course of the arteries. Despite symptomatic treatement, skin lesions progressed to nonhealing ulcers and became necrotic, and amputation of the second and fifth fingers of right hand was required. The surgical biopsy specimen revealed circumferential calcium deposition in the intima and media of the arteries by von Kossa stain. Two months after the operation, the patient died of cachexia.