{"id":7527,"date":"2022-11-22T13:00:22","date_gmt":"2022-11-22T10:00:22","guid":{"rendered":"https:\/\/urbancare.clinic\/complete-resolution-of-calciphylaxis-in-a-renal-transplant-patient-with-calcifediol\/"},"modified":"2022-11-22T13:00:22","modified_gmt":"2022-11-22T10:00:22","slug":"risoluzione-completa-della-calcifilassi-in-un-paziente-sottoposto-a-trapianto-renale-con-calcifediolo","status":"publish","type":"post","link":"https:\/\/urbancare.clinic\/it\/complete-resolution-of-calciphylaxis-in-a-renal-transplant-patient-with-calcifediol\/","title":{"rendered":"Risoluzione completa della calcifilassi in un paziente sottoposto a trapianto renale con calcifediolo"},"content":{"rendered":"<div><img decoding=\"async\" src=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/complete-resolution-of-calciphylaxis-in-a-renal-transplant-patient-with-calcifediol.jpg\" class=\"ff-og-image-inserted\" style=\"display:none\"><\/div>\n<p><span class=\"highwire-journal-article-marker-start\"><\/span><\/p>\n<p id=\"p-1\">Presentazione:<\/p>\n<p id=\"p-2\">Una donna di 62 anni con un trapianto di rene da donatore vivente nel 2008 complicato da malattia renale cronica III, nefrite da lupus, ipotiroidismo (ma nessuna storia di diabete) presentava ulcerazioni ischemiche dolorose, bilaterali, del polpaccio mediale (figura 1), che su la biopsia del punch ha rivelato la calcifilassi (figura 2). Il suo peso era di 66,3 kg, altezza 1,6 me indice di massa corporea di 25,9 kg\/m<sup>2<\/sup>. Era in idrossiclorochina, micofenolato e prednisone per lupus\/trapianto e levotiroxina 125 mcg al giorno per ipotiroidismo. Il suo armone paratiroideo intatto al basale (iPTH), calcio, fosforo... <\/p>\n<p><span class=\"highwire-journal-article-marker-end\"><\/span><a href=\"http:\/\/pmj.bmj.com\/cgi\/content\/short\/98\/1166\/e35?rss=1\">Fonte quotidiana medica<\/a><\/p>\n<p>","protected":false},"excerpt":{"rendered":"<p>Presentazione:<\/p>\n<p>Una donna di 62 anni sottoposta a trapianto di rene da donatore vivente nel 2008, affetta da malattia renale cronica di tipo III, nefrite lupica, ipotiroidismo (ma senza storia di diabete), si \u00e8 presentata con ulcere ischemiche dolorose, bilaterali, al polpaccio mediale (<cross-ref type=\"fig\" refid=\"F1\">Figura 1<\/cross-ref>), che alla biopsia perforante ha rivelato calcifilassi (<cross-ref type=\"fig\" refid=\"F2\">figura 2<\/cross-ref>). Il suo peso era 66,3 kg, altezza 1,6 m e indice di massa corporea di 25,9 kg\/m<sup>2<\/sup>. Assumeva idrossiclorochina, micofenolato e prednisone per lupus\/trapianto e levotiroxina 125 mcg al giorno per ipotiroidismo. I suoi livelli basali di paratiroide intatta (iPTH), calcio, fosforo e 25-idrossivitamina D erano rispettivamente 372 pg\/mL, 9,4 mg\/dL, 3,8 mg\/dL e 17,4 ng\/mL (<cross-ref type=\"tbl\" refid=\"T1\">Tabella 1<\/cross-ref>raffiguranti i laboratori e i cambiamenti dei farmaci nel tempo). Assumeva calcitriolo (0,75 mcg\/giorno), ergocalciferolo (50.000 unit\u00e0 settimanali) e cinacalcet 30 mcg a giorni alterni. Abbiamo iniziato con calcifediolo 30 mg, che \u00e8 stato poi aumentato a 60 mg al giorno. Le sue dosi di calcitriolo ed ergocalciferolo sono state ridotte lentamente, mentre il cinacalcet \u00e8 rimasto invariato. Questo\u2026<\/p>","protected":false},"author":2,"featured_media":7528,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"Default","format":"standard","meta":{"page_builder":"","fifu_image_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/complete-resolution-of-calciphylaxis-in-a-renal-transplant-patient-with-calcifediol.jpg","fifu_image_alt":"","footnotes":""},"categories":[185],"tags":[],"class_list":["post-7527","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-medical-articles"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Complete resolution of calciphylaxis in a renal transplant patient with Calcifediol - Urban Care Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbancare.clinic\/it\/risoluzione-completa-della-calcifilassi-in-un-paziente-sottoposto-a-trapianto-renale-con-calcifediolo\/\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Complete resolution of calciphylaxis in a renal transplant patient with Calcifediol - Urban Care Clinic\" \/>\n<meta property=\"og:description\" content=\"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 and 25-hydroxy-vitamin D was 372 pg\/mL, 9.4 mg\/dL, 3.8 mg\/dL and 17.4 ng\/mL, respectively (table 1depicting laboratories and medication changes over time). She was on calcitriol (0.75 mcg\/daily), ergocalciferol (50 000 units weekly) and cinacalcet 30 mcg every other day. We started her on calcifediol 30 mg, which was later increased to 60 mg daily. Her calcitriol and ergocalciferol doses were reduced slowly, while cinacalcet remained the same. 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