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Warfarin Induced Non-Uremic Calciphylaxis
Michael Kanan1, Farzana Hoque2
1Saint Louis University School of Medicine.
Journal of Brown Hospital Medicine
|July 4, 2025
Summary
Warfarin-induced non-uremic calciphylaxis is a rare complication causing skin necrosis. Early diagnosis and treatment adjustments, like switching anticoagulants, are crucial for managing this severe condition.
Area of Science:
- Vascular Medicine
- Dermatology
- Nephrology
Background:
- Calciphylaxis is a rare, severe condition involving vascular calcification and thrombosis.
- While often linked to end-stage renal disease, it can occur in non-uremic patients, particularly those on long-term warfarin therapy.
Observation:
- A 78-year-old woman with a mechanical aortic valve on warfarin developed painful, necrotic skin ulcerations.
- Skin biopsy confirmed warfarin-induced non-uremic calciphylaxis.
Findings:
- Discontinuation of warfarin and transition to low molecular weight heparin was performed.
- Intravenous sodium thiosulfate treatment was initiated.
Implications:
- This case highlights the importance of recognizing non-uremic calciphylaxis in warfarin-treated patients.
- Early diagnosis, multidisciplinary management, and shared decision-making are vital for balancing anticoagulation risks and calciphylaxis complications.
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