Isolated Mesenteric Calciphylaxis With Ischemic Colitis in a Hemodialysis Patient Without Active Cutaneous...

Area of Science:

• Nephrology
• Vascular Biology
• Gastroenterology

Background:

• Calciphylaxis (calcific uremic arteriolopathy) is a severe systemic disease linked to chronic kidney failure.
• Histopathology reveals small-vessel calcification, intimal hyperplasia, and microthrombi, causing tissue necrosis.
• Typically presents as painful cutaneous lesions; visceral involvement is rare and usually co-occurs with skin lesions.

Observation:

• A case report of a male patient undergoing hemodialysis who presented with mesenteric calciphylaxis and ischemic colitis.
• Notably, this patient had no active cutaneous lesions, distinguishing it from previously documented cases of visceral calciphylaxis.
• The patient had a history of penile calciphylaxis, which had healed 12 months prior to the mesenteric presentation.

Findings:

• This case represents the first documented instance of isolated mesenteric calciphylaxis.
• Treatment involved sodium thiosulfate, vitamin K, and surgical resection of the affected mesenteric tissue.
• The patient's prior penile calciphylaxis was treated with sodium thiosulfate and management of mineral and bone disorder parameters.

Implications:

• This case highlights the potential for calciphylaxis to manifest in visceral organs without cutaneous involvement, posing diagnostic challenges.
• It raises critical questions regarding optimal duration of sodium thiosulfate therapy, methods for monitoring disease activity, and the implications for kidney transplant eligibility.
• Further research is needed to understand the pathophysiology and management of isolated visceral calciphylaxis.