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Fatal calciphylaxis in two patients with giant cell arteritis
K Brouns1, E Verbeken, H Degreef
1Department of General Internal Medicine, University Hospital Gasthuisberg, Dienst Algemene Inwendige Geneeskunde, UZ Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Clinical Rheumatology
|July 28, 2006
Summary
Two elderly women developed fatal calciphylaxis during treatment for giant cell arteritis. This rare condition occurred despite near-normal kidney function, prompting investigation into potential links.
Area of Science:
- Vascular Medicine
- Nephrology
- Rheumatology
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium arteries.
- Calciphylaxis is a rare and severe condition characterized by vascular calcification and skin necrosis, often associated with end-stage renal disease.
- Treatment for GCA typically involves corticosteroids, which can have significant side effects.
Observation:
- Two elderly female patients with GCA were treated and developed fatal calciphylaxis.
- Both patients exhibited nearly normal renal function at the time of calciphylaxis development.
- The onset of calciphylaxis occurred during the course of GCA treatment.
Findings:
- The cases highlight a potential, albeit rare, association between GCA treatment and the development of calciphylaxis.
- The occurrence in patients with preserved renal function challenges typical risk factor profiles for calciphylaxis.
- Mechanisms linking GCA, its treatment, and calciphylaxis require further investigation.
Implications:
- Clinicians should maintain a high index of suspicion for calciphylaxis in GCA patients, even with normal renal function.
- Further research is needed to elucidate the pathophysiology underlying this association.
- Exploring alternative or adjunctive therapies for GCA may be warranted to mitigate this risk.