North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Arlington
Specialty
Internal Medicine
Document Type
Poster
Publication Date
2025
Keywords
necrosis, calciphylaxis, calcific uremic arteriolopathy
Disciplines
Internal Medicine | Medicine and Health Sciences | Nutritional and Metabolic Diseases
Abstract
Calciphylaxis is a rare but serious condition characterized by the calcification and thrombosis of small blood vessels, predominantly affecting patients with end-stage renal disease (ESRD). Diagnosis can be challenging due to overlapping features with other vascular conditions, such as warfarin-induced skin necrosis (WSN). We present a case of a patient with ESRD and typical risk factors—peritoneal dialysis, hyperparathyroidism, and warfarin use—who exhibited classic skin findings suggestive of calciphylaxis. However, two skin biopsies were inconclusive. Management involved addressing the patient's calciphylaxis risk factors, optimizing dialysis, and initiating sodium thiosulfate therapy. The case was further complicated by the need to replace warfarin, as current guidelines only approve its use for patients with mechanical heart valves.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Luk, Sienna; Parekh, Harshil; Singh, Vaishnavi; Bhatty, Darshan; and Karmegam, Sathish, "When Skin Necrosis Mimics: Diagnostic and Therapeutic Challenges of Calciphylaxis in a CKD Patient with a Mechanical Heart Valve" (2025). North Texas Research Forum 2025. 20.
https://scholarlycommons.hcahealthcare.com/northtexas2025/20