Gastric calciphylaxis in a patient with a functioning renal allograft

Area of Science:

• Nephrology
• Gastroenterology
• Pathology

Background:

• Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a vascular complication often seen in dialysis patients.
• CUA has been documented in renal transplant recipients, though less commonly than in the dialysis population.
• While skin manifestations are most frequent, visceral CUA is seldom reported.

Observation:

• A patient with a long-term functioning kidney transplant developed visceral calciphylaxis.
• The calciphylaxis manifested in a Dieulafoy lesion within the gastrointestinal tract.
• The patient required a gastrectomy to manage the condition.

Findings:

• Histopathological examination confirmed the features of calcific uremic arteriolopathy.
• This case represents a rare instance of visceral CUA in a post-transplant setting.
• A review of existing literature on CUA in transplant patients was conducted.

Implications:

• This case underscores the potential for rare but severe visceral manifestations of CUA in renal transplant recipients.
• Increased clinical suspicion for visceral CUA may be warranted in transplant patients presenting with unexplained gastrointestinal complications.
• Management strategies for visceral CUA in this population may require multidisciplinary approaches, including surgical intervention.