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Related Experiment Videos

Calciphylaxis leading to penile necrosis.

Imran Haider, Muhammad Siddiqui, Wisam Naji

    JPMA. the Journal of the Pakistan Medical Association
    |September 26, 2014
    PubMed
    Summary

    Penile gangrene, a rare condition in end-stage renal disease (ESRD) patients, indicates poor prognosis and vascular calcification. This case highlights the challenges in understanding and treating this life-threatening disease, leading to septic shock.

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    Area of Science:

    • Nephrology
    • Vascular Surgery
    • Dermatology

    Background:

    • Penile gangrene is a rare but severe complication, particularly in patients with end-stage renal disease (ESRD).
    • It is associated with metastatic vascular calcification and carries a poor prognosis.
    • The underlying pathogenesis and optimal treatment strategies remain poorly understood and debated.

    Observation:

    • A 61-year-old male with diabetes mellitus and chronic renal failure undergoing hemodialysis presented with four weeks of worsening groin pain.
    • Physical examination revealed dry gangrene of the glans penis.
    • Computed tomography (CT) demonstrated diffuse calcification of the external and internal iliac arteries.

    Findings:

    • Penile cultures identified multiple organisms, suggesting a complex infectious or inflammatory process.

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  • The patient subsequently developed calciphylaxis of the right anterior thigh.
  • Despite appropriate antibiotic therapy, his condition did not improve, necessitating intensive care unit (ICU) admission and vasopressor support.

    • Implications:

    • This case underscores the critical association between penile gangrene, ESRD, and widespread vascular calcification.
    • It highlights the aggressive and often fatal trajectory of calciphylaxis in this patient population.
    • Further research into the pathogenesis and novel therapeutic approaches for penile gangrene and calciphylaxis in ESRD patients is warranted.