COVID-19:灾难性多器官钙化反应的独特案例

IF 1 4区 医学 Q3 MEDICINE, LEGAL
Andrew Johnson, Kathryn Manocchia, Marisa Jacob-Leonce
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引用次数: 0

摘要

摘要:钙化反应或钙化尿毒症小动脉病是一种罕见的疾病,其病理生理机制尚不清楚。它通常与引起钙代谢异常的疾病有关,如终末期肾病(ESRD)和甲状旁腺功能亢进。虽然它最常影响皮肤,但也有涉及皮肤外器官的报道,称为系统性钙化反应。有趣的是,现在已经确定了与钙化反应发生有关的其他危险因素,包括近期感染、皮质类固醇或华法林的使用以及糖尿病、自身免疫性疾病和蛋白C或S缺乏。我们报告一名48岁女性患者,有人类免疫缺陷病毒感染史,近期因急性胰腺炎和COVID-19住院,表现为非特异性腹痛、虚弱和轻度红斑性皮肤病变。随后,患者出现急性视力丧失、严重高血压和急性肾损伤,皮肤病变明显加重。最终,病人病情迅速恶化并死亡。尸检证实皮肤钙化反应,影响体表面积50%以上,内脏钙化反应广泛累及器官,最显著的是心脏和肺部。该病例强调了将COVID-19和其他非尿毒症风险因素视为发生灾难性全身性钙化反应的触发因素的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Getting Crunchy With COVID-19: A Unique Case of Catastrophic Multiorgan Calciphylaxis.

Abstract: Calciphylaxis, or calcific uremic arteriolopathy, is a rare condition with a poorly understood pathophysiology. It is often associated with diseases that cause abnormalities in calcium metabolism, such as end-stage renal disease (ESRD) and hyperparathyroidism. While it most often affects the skin, involvement of extracutaneous organs, called systemic calciphylaxis, has been reported.Interestingly, other risk factors have now been identified with the development of calciphylaxis including recent infections, corticosteroid or warfarin use as well as diabetes mellitus, autoimmune diseases, and protein C or S deficiency.We present a 48-year-old female patient with a history of human immunodeficiency virus infection, and recent hospitalizations for acute pancreatitis and COVID-19 who presents with nonspecific abdominal pain, weakness, and mild erythematous skin lesions. Subsequently, the patient developed acute vision loss, severe hypertension, and acute kidney injury with significantly worsening skin lesions. Ultimately, the patient deteriorated rapidly and succumbed. At autopsy, cutaneous calciphylaxis was confirmed, affecting over 50% of body surface area as well as widespread organ involvement by visceral calciphylaxis, most strikingly in the heart and lungs. This case highlights the importance of considering COVID-19 and other nonuremic risk factors as being a trigger for developing catastrophic systemic calciphylaxis.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
103
审稿时长
4-8 weeks
期刊介绍: Drawing on the expertise of leading forensic pathologists, lawyers, and criminologists, The American Journal of Forensic Medicine and Pathology presents up-to-date coverage of forensic medical practices worldwide. Each issue of the journal features original articles on new examination and documentation procedures. While most articles are available as web based articles, PDF and in ePub reader format, some earlier articles do not have PDFs available. If you would like to view an article in the ePub format, you will need to download an ePub reader to view this file, a number of which are available for free online.
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