Calciphylaxis in primary hyperparathyroidism: a case report and brief review

A 52-year-old woman was admitted with complaints of nonhealing skin ulcers. The laboratory assessment showed a calcium level of 13.2 mg/dL (normal 8.4-10.2 mg/dL), albumin 2 g/dL (normal 3.5-4.8 g/dL), corrected calcium 14.8 mg/dL, phosphorus 1.4 mg/dL (normal 2.4-4.7 mg/dL), creatinine 0.7 mg/dL (normal 0.5-1.2 mg/dL), parathyroid hormone 893.3 pg/mL (normal 11.1-79.5 pg/mL). A technetium-sestamibi scan showed a left inferior parathyroid adenoma. The patient underwent a parathyroidectomy. Pathology showed a parathyroid adenoma. Despite treatment of her skin wounds with broad spectrum antibiotics and local wound care, the patient died of overwhelming sepsis. Calciphylaxis is a rare but serious disorder that leads to skin and soft tissue necrosis and requires prompt diagnosis and management.