The calcium invasion: Calciphylaxis in Lupus.

Area of Science:

• Vascular Biology
• Nephrology
• Dermatology

Background:

• Calciphylaxis is a rare, severe condition characterized by calcification of small blood vessels leading to skin necrosis.
• Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organs.
• Long-term, inappropriate corticosteroid use is a potential risk factor for various complications.

Observation:

• A 52-year-old woman with a history of SLE, treated with oral steroids for 18 years, presented with renal impairment.
• She subsequently developed severe skin necrosis and gangrene of her right hand.
• Imaging revealed subcutaneous calcium deposition, bilateral renal stones, and widespread vascular calcifications.

Findings:

• The patient was diagnosed with calciphylaxis, a condition linked to her underlying SLE and prolonged steroid therapy.
• Despite medical intervention for calciphylaxis, her condition rapidly deteriorated.
• The patient ultimately succumbed to a myocardial infarction.

Implications:

• This case highlights the severe morbidity and mortality associated with calciphylaxis, particularly in patients with autoimmune diseases.
• It underscores the potential complications of long-term, inappropriate corticosteroid use.
• Further research is needed to elucidate the pathophysiology of calciphylaxis and develop effective therapeutic strategies.