Related Experiment Video
Updated: May 23, 2025
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Getting Crunchy With COVID-19: A Unique Case of Catastrophic Multiorgan Calciphylaxis
Andrew Johnson1, Kathryn Manocchia, Marisa Jacob-Leonce
1Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY.
Insights
Calciphylaxis, a rare condition, can be triggered by non-uremic factors like COVID-19. This case shows severe systemic calciphylaxis affecting skin and organs, leading to a fatal outcome.
Area of Science:
- Vascular Medicine
- Nephrology
- Dermatology
Background:
- Calciphylaxis (calcific uremic arteriolopathy) is a rare condition with unclear pathophysiology, often linked to end-stage renal disease (ESRD) and hyperparathyroidism.
- While typically affecting the skin, systemic calciphylaxis involves extracutaneous organs.
- Emerging risk factors include infections, corticosteroid/warfarin use, diabetes, autoimmune diseases, and protein C/S deficiency.
Purpose of the Study:
- To present a case of catastrophic systemic calciphylaxis.
- To highlight the potential role of COVID-19 and non-uremic factors in triggering calciphylaxis.
Main Methods:
- Case report of a 48-year-old female with HIV, pancreatitis, and COVID-19.
- Clinical presentation included abdominal pain, weakness, skin lesions, vision loss, hypertension, and acute kidney injury.
- Autopsy confirmed extensive cutaneous and visceral calciphylaxis, notably in the heart and lungs.
Main Results:
- The patient experienced rapid deterioration and succumbed to the condition.
- Autopsy revealed extensive cutaneous calciphylaxis (>50% body surface area) and widespread visceral calciphylaxis.
- Heart and lungs showed the most striking organ involvement.
Conclusions:
- COVID-19 and other non-uremic factors should be considered potential triggers for systemic calciphylaxis.
- This case underscores the catastrophic potential of systemic calciphylaxis in non-uremic patients.
- Prompt recognition and management of non-uremic risk factors are crucial.
Abstract:
Calciphylaxis, or calcific uremic arteriolopathy, is a rare condition with a poorly understood pathophysiology. It is often associated with diseases that cause abnormalities in calcium metabolism, such as end-stage renal disease (ESRD) and hyperparathyroidism. While it most often affects the skin, involvement of extracutaneous organs, called systemic calciphylaxis, has been reported.Interestingly, other risk factors have now been identified with the development of calciphylaxis including recent infections, corticosteroid or warfarin use as well as diabetes mellitus, autoimmune diseases, and protein C or S deficiency.We present a 48-year-old female patient with a history of human immunodeficiency virus infection, and recent hospitalizations for acute pancreatitis and COVID-19 who presents with nonspecific abdominal pain, weakness, and mild erythematous skin lesions. Subsequently, the patient developed acute vision loss, severe hypertension, and acute kidney injury with significantly worsening skin lesions. Ultimately, the patient deteriorated rapidly and succumbed. At autopsy, cutaneous calciphylaxis was confirmed, affecting over 50% of body surface area as well as widespread organ involvement by visceral calciphylaxis, most strikingly in the heart and lungs. This case highlights the importance of considering COVID-19 and other nonuremic risk factors as being a trigger for developing catastrophic systemic calciphylaxis.
Related Concept Videos
00:42Cross-reactivity
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...