Presentation:
A 62-year-old woman with a Living Donor Kidney transplant in 2008 complicated with chronic kidney disease III, lupus nephritis, hypothyroidism (but no history of diabetes) presented with painful, bilateral, medial calf ischaemic ulcerations (figure 1), which on punch biopsy revealed calciphylaxis (figure 2). Her weight was 66.3 kg, height 1.6 m and body mass index of 25.9 kg/m2. She was on hydroxychloroquine, mycophenolate and prednisone for lupus/transplant and levothyroxine 125 mcg daily for hypothyroidism. Her baseline intact parathyroid harmone (iPTH), calcium, phosphorus …
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