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Winter 2016, Vol. 24 No. 4

Hong Kong J. Dermatol. Venereol. (2016) 24, 184-190


Review Article

A case series and clinical update on calciphylaxis

鈣化防禦症的病例系列和臨床更新

A Grant and S Lee 李啟焱

Abstract

Department of Dermatology, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia Calciphylaxis is a rare disorder characterised by microvascular calcification and thrombosis often leading to rapidly progressing ulceration and tissue necrosis. It most commonly affects patients with chronic renal disease. Clinical findings are variable although painful lower limb lesions are characteristic. Some cases can be diagnosed on clinical grounds. However there are useful diagnostic adjuncts. Differential diagnosis includes atherosclerotic vascular disease, pyoderma gangrenosum, vasculitis, necrobiosis lipoidica and warfarin necrosis. Sadly, treatment remains largely supportive. There is a need for heightened interest and targeted research.

鈣化防禦症是一種罕見的疾病,其特徵為微血管的鈣化和血栓形成,常導致快速惡化的潰瘍並組織壞死。此病最常見於慢性腎病患者,其臨床表現多樣化,最具代表性的當是疼痛的下肢損傷。部份病例可經臨床診斷,亦有可靠的診斷輔助檢查。鑑別診斷包括動脈粥樣硬化性血管疾病、壞疽性膿皮病、血管炎、脂性漸進性壞死和華法林壞死。可悲的是,治療大多只限於支持性質,故提高醫學界對此病的興趣並進行針對性的研究實是刻不容緩。

Keywords: Amputation, calciphylaxis, diabetes, mortality, renal failure

關鍵詞: 截肢、鈣化防禦症、糖尿病、死亡率、腎衰竭