ABSTRACT
Calciphylaxis is a life-threatening complication most often associated with chronic kidney disease that occurs as a result of the deposition of calcium in dermal and adipose microvasculature. However, this condition may also be seen in patients with acute kidney injury. The high morbidity and mortality rates associated with calciphylaxis highlight the importance to correctly diagnose and treat this condition. However, calciphylaxis remains a diagnosis that may be clinically challenging to make. Here, we review the literature on uremic calciphylaxis with a focus on its pathophysiology, clinical presentation, advances in diagnostic tools, and treatment strategies. We also discuss the unique histopathological features of calciphylaxis and contrast it with those of other forms of general vessel calcification. This review emphasizes the need for multidisciplinary collaboration including nephrology, dermatology, and palliative care to ultimately provide the best possible care to patients with calciphylaxis.
Subject(s)
Calciphylaxis , Kidney Failure, Chronic , Renal Insufficiency, Chronic , Vascular Calcification , Humans , Calciphylaxis/diagnosis , Calciphylaxis/etiology , Calciphylaxis/therapy , Vascular Calcification/etiology , Renal Insufficiency, Chronic/complications , Calcium , Obesity/complications , Kidney Failure, Chronic/therapySubject(s)
Drug Hypersensitivity Syndrome , Hypersensitivity , Pancytopenia , Humans , Pancytopenia/chemically induced , Pancytopenia/pathology , Eosinophils/pathology , Skin/pathology , Drug Hypersensitivity Syndrome/diagnosis , Drug Hypersensitivity Syndrome/etiology , Drug Hypersensitivity Syndrome/pathology , Biopsy , Hypersensitivity/pathologyABSTRACT
Cutaneous small vessel vasculitis (CSVV) or leukocytoclastic vasculitis (LCV) is a group of immune complex mediated vasculitides that affect dermal capillaries or post-capillary venules and classically presents as lower extremity palpable purpura. CSVV can be subdivided by antibody type and clinical features. In patients presenting with signs of LCV and ANCA positivity, clinicopathologic correlation is important in characterizing the type of vasculitis. We report an uncommon case of IgA vasculitis with concurrent ANCA-positivity attributed to bacterial endocarditis.
Subject(s)
Endocarditis, Bacterial , IgA Vasculitis , Polyarteritis Nodosa , Vasculitis , Humans , Antibodies, Antineutrophil Cytoplasmic , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/diagnosisABSTRACT
Adverse cutaneous reactions associated with the immune checkpoint inhibitor (ICI) pembrolizumab are well documented, yet life-threatening reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) are infrequent.1,2 We present a case of pembrolizumab-induced TEN in a patient with metastatic esophageal adenocarcinoma who was successfully treated with cyclosporine and systemic corticosteroids.
