SUCCESSFUL CALCIPHYLAXIS TREATMENT WITH PARENTERAL VITAMIN K

DANIEL CHRISTIADI1, RICHARD F. SINGER1,2

1The Canberra Hospital, Woden, ACT, Australia; 2Medical School, Australian National University, Acton, ACT, Australia

Background: Calciphylaxis is a rare condition that usually occurs in patients requiring maintenance dialysis. One trigger for this condition may be vitamin K deficiency. Vitamin K is required for activation of matrix-Gla protein, a major inhibitor of calcification in tissue

Case Report: We report the clinical course of a 43 years old, obese, White female who presented with biopsy proven calciphylaxis one year after commencing haemodialysis. The calciphylaxis occurred after recovery from ischaemic gut which had resulted in short gut syndrome and multiple vitamin deficiencies, including vitamin K deficiency. The calciphylaxis  completely resolved with intravenous vitamin K therapy, local wound care and increased dialysis frequency. Neither bisphosphonate, cinacalcet, sodium thiosulfate nor surgical parathyroidectomy were required for resolution of the calciphylaxis.

Conclusions: Vitamin K deficiency appears to be a likely contributor to calciphylaxis. Correction of deficiency and increased dialysis frequency were associated with complete resolution in this case, without the need for additional intervention.

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