| Calciphylaxis due to Primary Hyperparathyroidism. | |
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MedLine Citation:
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PMID: 21324820 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective: Calciphylaxis is a rare and life-threatening disorder. The objective of this paper is to determine when and how to workup calciphylaxis for early diagnosis and to delineate medical versus surgical management of the disease.Methods: Review of evidence based medical literature on calciphylaxis due to primary, secondary and tertiary hyperparathyroidism.Results: Calciphylaxis is usually associated with secondary and tertiary hyperparathyroidism. However, calciphylaxis can also be seen in the absence of chronic renal failure and has been reported in patients with primary hyperparathyroidism, due to a parathyroid adenoma or carcinoma. Calciphylaxis occurs when the levels of calcium and phosphate in the blood exceed their solubility level, leading to calcium-phosphate deposits in arteries that compromise the vasculature. These ischemic changes result in plaque-like lesions that progress to painful nodules. The diagnosis of calciphylaxis is based on physical exam findings, laboratory, and histopathological findings. When medical therapy has failed in the setting of secondary/tertiary hyperparathyroidism with calciphylaxis, parathyroidectomy is the preferred treatment. In primary hyperparathyroidism, early recognition and aggressive wound care with debridement are important in managing this condition. However, resection of the offending parathyroid gland should be strongly considered.Conclusion: When calciphylaxis is present, early detection is critical to the successful management of this condition. Although medical therapy can be effective, surgical resection of the diseased parathyroid glands can be curative and potentially life saving. A multidisciplinary approach involving early diagnosis, aggressive medical management, operative debridement, and parathyroidectomy has the best chance of improving survival in calciphylaxis. |
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Authors:
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Rashmi Roy; James A Lee |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-16 |
Journal Detail:
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Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Volume: - ISSN: 1934-2403 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: - |
Other Details:
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Languages: ENG Pagination: 1-11 Citation Subset: - |
Affiliation:
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Dept. of Endocrine Surgery, Johns Hopkins University, 600 N. Wolfe Street, Blalock 7 - Rm 606, Baltimore, MD 21287. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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