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Calciphylaxis in pediatric end-stage renal disease
Abubakr A Imam1, Tej K Mattoo, Gaurav Kapur
1Division of Nephrology and Hypertension, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA. aimam@med.wayne.edu
Pediatric Nephrology (Berlin, Germany)
|September 1, 2005
Summary
Calciphylaxis, a severe complication of end-stage renal disease (ESRD), rarely affects children. This study details a pediatric case with unusual lab findings, highlighting treatment challenges and poor outcomes in pediatric calciphylaxis.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Dermatology
Background:
- Calciphylaxis is a rare, life-threatening condition often seen in adult end-stage renal disease (ESRD) patients.
- Etiology is unclear but linked to high calcium-phosphorus product and parathyroid hormone (PTH) levels.
Observation:
- This review focuses on calciphylaxis in pediatric ESRD patients (<18 years).
- A case report details a child with severe calciphylaxis presenting with leg pain, muscle tenderness, and gait difficulty.
- The patient exhibited low serum PTH and normal calcium-phosphorus product, atypical for calciphylaxis.
Findings:
- Diagnosis was confirmed via muscle biopsy.
- Treatment with low calcium dialysate and sevelamer was ineffective.
- The patient developed extensive soft tissue calcification and skin ulcerations.
Implications:
- This case underscores the challenges in diagnosing and treating pediatric calciphylaxis, especially with atypical laboratory values.
- The poor treatment response and fatal outcome highlight the aggressive nature of calciphylaxis in this population.
- Further research is needed to understand and manage calciphylaxis in pediatric ESRD.