Minimal Change Nephrotic Syndrome Sequentially Complicated by Acute Kidney Injury and Painful Skin Ulcers due to Calciphylaxis

Intern Med. 2016;55(22):3315-3320. doi: 10.2169/internalmedicine.55.7180. Epub 2016 Nov 15.

Abstract

Calciphylaxis is rare cutaneous manifestation associated with painful skin ulceration and necrosis. It primarily occurs in patients with end-stage chronic kidney disease. In this report, we would like to show our experience with a male patient presenting with minimal change nephrotic syndrome that was sequentially complicated by acute kidney injury and painful ulcerative cutaneous lesions due to calciphylaxis. There seemed to be several contributing factors, including a disturbance of the patient's mineral metabolism and the systemic use of glucocorticoids and warfarin. Various concerns regarding the diagnostic and therapeutic conundrums that were encountered in the present case are also discussed.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / therapy
  • Adult
  • Calciphylaxis / complications*
  • Calciphylaxis / pathology
  • Calciphylaxis / therapy
  • Humans
  • Male
  • Nephrosis, Lipoid / complications*
  • Nephrosis, Lipoid / pathology
  • Nephrosis, Lipoid / therapy
  • Skin Ulcer / etiology*
  • Skin Ulcer / pathology
  • Skin Ulcer / therapy
  • Warfarin / therapeutic use

Substances

  • Warfarin