medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2020, Número 1

<< Anterior Siguiente >>

Acta Med 2020; 18 (1)


Calcifilaxis

Cano ALE, Rodríguez WFL

Idioma: Español
Referencias bibliográficas: 70
Paginas: 50-60
Archivo PDF: 278.31 Kb.


RESUMEN

La calcifilaxis es un síndrome que se caracteriza por la acumulación de cristales de hidroxiapatita en la capa muscular de las arteriolas localizadas en la dermis en el tejido subcutáneo y en el visceral. Este síndrome fue descrito por primera vez por Selye en 1962. La etiología de la calcifilaxis es multifactorial y puede dividirse en dos: urémica, que se halla en pacientes con terapia de sustitución renal, y no urémica, la cual se manifiesta en pacientes con enfermedades autoinmunes y oncológicas, así como con procedimientos médicos. Clínicamente se observan úlceras con forma de estrella y gangrena con escara negra que son propensas a infección. El diagnóstico de la calcifilaxis es complicado debido al poco conocimiento que se tiene de la enfermedad. Un estudio realizado en Japón en el año 2013 evidenció que hasta 60% de los nefrólogos desconocen la existencia de esta enfermedad. Para su tratamiento se recomienda un equipo multidisciplinario para que el tratamiento de elección sea por medio de antibióticos de amplio espectro, analgésicos basados en opiáceos o por tratamiento quirúrgico. El pronóstico es reservado en cuanto a morbilidad y mortalidad debido a que la sobrevida es menor de 40% a un año posterior a su diagnóstico, por lo que su reconocimiento y tratamiento oportuno se vuelven de vital importancia. En general, la sepsis de foco en partes blandas es la causa de muerte más frecuente.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Brandenburg VM, Kramann R, Specht P, Ketteler M. Calciphylaxis in CKD and beyond. Nephrol Dial Transplant. 2012; 27 (4): 1314-1318.

  2. Oliveira TM, Frazão JM. Calciphylaxis: from the disease to the diseased. J Nephrol. 2015; 28 (5): 531-540.

  3. Rothe H, Brandenburg V, Haun M, Kollerits B, Kronenberg F, Ketteler M et al. Ecto-5-Nucleotidase CD73 (NT5E), vitamin D receptor and FGF23 gene polymorphisms may play a role in the development of calcific uremic arteriolopathy in dialysis patients. Data from the German Calciphylaxis Registry. PLoS One. 2017; 12 (2): e0172407.

  4. Richens G, Piepkorn MW, Krueger GG. Calcifying panniculitis associated with renal failure. A case of Selye’ calciphylaxis in man. J Am Acad Dermatol. 1982; 537-539.

  5. Ruggian JC, Maesaka JK, Fishbane S. Proximal calciphylaxis in four insulin-requiring diabetic hemodialysis patients. Am J Kidney Dis. 1996; 28 (3): 409-414.

  6. Nigwekar SU, Jiramongkolchai P, Wunderer F, Bloch E, Ichinose R, Nazarian RM et al. Increased bone morphogenetic protein signaling in the cutaneous vasculature of patients with calciphylaxis. Am J Nephrol. 2017; 46 (5): 429-438.

  7. Nigwekar SU, Thadhani R, Brandenburg VM. Calciphylaxis. N Engl J Med. 2018 3; 378 (18): 1704-1714.

  8. Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017; 389: 1238-1252.

  9. Kalajian AH, Malhotra PS, Callen JP, Parker LP. Calciphylaxis with normal renal and parathyroid function: not as rare as previously believed. Arch Dermatol. 2009; 145 (4): 451-458.

  10. Hayashi M. Calciphylaxis: diagnosis and clinical features. Clin Exp Nephrol. 2013; 17 (4): 498-503.

  11. Brandenburg VM, Kramann R, Rothe H, Kaesler N, Korbiel J, Specht P et al. Calcific uraemic arteriolopathy (calciphylaxis): data from a large nationwide registry. Nephrol Dial Transplant. 2017; 32 (1): 126-132.

  12. Mazhar AR, Johnson RJ, Gillen D, Stivelman JC, Ryan MJ, Davis CL et al. Risk factors and mortality associated with calciphylaxis in end-stage renal disease. Kidney Int. 2001; 60 (1): 324-332.

  13. Angelis M, Wong LL, Myers SA, Wong LM.Calciphylaxis in patients on hemodialysis: a prevalence study. Surgery 1997; 122: 1083-1089.

  14. Nigwekar SU, Zhao S, Wenger J, Hymes JL, Maddux FW, Thadhani RI et al. A nationally representative study of calcific uremic arteriolopathy risk factors. J Am Soc Nephrol. 2016; 27: 3421-3429.

  15. Santos PW, He J, Tuffaha A, Wetmore JB. Clinical characteristics and risk factors associated with mortality in calcific uremic arteriolopathy. Int Urol Nephrol. 2017; 49 (12): 2247-2256.

  16. Sreedhar A, Sheikh HA, Scagliotti CJ, Nair R. Advanced-stage calciphylaxis: Think before you punch. Cleve Clin J Med. 2016; 83 (8): 562-564.

  17. Brandenburg V, Al-Fakhri N, Nemeth K, Goettsch C, Schurgers LJ, Vermeer C et al. Calcification inhibitors in vascular calciphylaxis associated with normal renal function. Thromb Haemost. 2012; 108 (6): 1241-1243.

  18. Lee JL, Naguwa SM, Cheema G, Gershwin ME. Recognizing calcific uremic arteriolopathy in autoimmune disease: an emerging mimicker of vasculitis. Autoimmun Rev. 2008; 7 (8): 638-643.

  19. Brandenburg VM, Kramann R, Rothe H. Calcific uraemic arteriolopathy (calciphylaxis): data from a large nationwide registry. Nephrol Dial Transplant. 2017; 32: 126-132.

  20. Hayashi M Takamatsu I, Kanno Y, Yoshida T, Abe T, Sato Y; Japanese Calciphylaxis Study Group. A case-control study of calciphylaxis in Japanese end-stage renal disease patients. Nephrol Dial Transplant. 2012; 27 (4): 1580-1584.

  21. Selye H, Gentile G, Prioreschi P. Cutaneous molt induced by calciphylaxis in the rat. Science. 1961; 134: 1876-1877.

  22. Wilmer WA, Magro CM. Calciphylaxis: emerging concepts in prevention, diagnosis and treatment. Semin Dial. 2002; 15: 172-286.

  23. Jeong HS, Dominguez AR. Calciphylaxis: Controversies in Pathogenesis, Diagnosis and Treatment. Am J Med Sci. 2016; 351 (2): 217-227.

  24. Sowers KM, Hayden MR. Calcific uremic arteriolopathy: pathophysiology, reactive oxygen species and therapeutic approaches. Oxid Med Cell Longev. 2010; 3 (2): 109-121.

  25. Schafer C, Heiss A, Schwarz A, Westenfeld R, Ketteler M, Floege J, Muller-Esterl W et al. The serum protein alpha 2 Heremans-Schmid glycoprotein/fetuin-A is a systemically acting inhibitor of ectopic calcification. J Clin Invest. 2003; 112: 357-366.

  26. Amann R, Brandenburg VM, Schurgers LJ, Ketteler M, Westphal S, Leisten I et al. Novel insights into osteogenesis and matrix remodelling associated with calcific uraemic arteriolopathy. Nephrol Dial Transplant. 2013; 28: 856-868.

  27. Griethe W, Schmitt R, Jurgensen JS, Bachmann S, Eckardt KU, Schindler R: Bone morphogenic protein-4 expression in vascular lesions of calciphylaxis. J Nephrol. 2003; 16: 728-732.

  28. Luo G, Ducy P, McKee MD, Pinero GJ, Loyer E, Behringer RR et al. Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein. Nature. 1997; 386: 78-81.

  29. Nigwekar SU, Bloch DB, Nazarian RM, Vermeer C, Booth SL, Xu D et al. Vitamin K dependent carboxylation of matrix Gla protein influences the risk of calciphylaxis. J Am Soc Nephrol. 2017; 28: 1717-1722.

  30. Mathur RV, Shortland JR, El Nahas AM. Calciphylaxis. Postgrad Med J. 2001; 77 (911): 557-561.

  31. Lebreton JP, Joisel F, Raoult JP, Lannuzel B, Rogez JP, Humbert G. Serum concentration of human alpha 2HS glycoprotein during the inflammatory process: evidence that alpha2 HS glycoprotein is a negative acute-phase reactant. J Clin Invest. 1979; 64: 1118-1129.

  32. Bleyer A, Choi M, Igwemezie B, de la Torre E, White WL. A case control study of proximal calciphylaxis. Am J Kidney Dis. 1998; 32: 376-383.

  33. Coates T, Kirkland G, Dymock R, Murphy BF, Brealey JK, Mathew TH et al. Cutaneous necrosis from calcific uremic arteriolopathy. Am J Kidney Dis. 1998; 32: 384-391.

  34. Price PA, Faus SA, Williamson MK. Warfarin causes rapid calcification of the elastic lamellae in rat arteries and heart valves. Arterioscler Thromb Vasc Biol. 1998; 18 (9): 1400- 1407.

  35. St Hilaire C, Ziegler SG, Markello TC, Brusco A, Groden C, Gill F, Carlson-Donohoe H et al. NT5E mutations and arterial calcifications. N Engl J Med. 2011; 364: 432-442.

  36. Pillai ICL, Li S, Romay M, Lam L, Lu Y, Huang J et al. Cardiac fibroblasts adopt osteogenic fates and can be targeted to attenuate pathological heart calcification. Cell Stem Cell. 2017; 20 (2): 218-232.e5.

  37. Mikhaylova L, Malmquist J, Nurminskaya M. Regulation of in vitro vascular calcification by BMP4, VEGF and Wnt3a. Calcif Tissue Int. 2007; 81: 372-381.

  38. Richens G, Piepkorn MW, Krueger GG. Calcifying panniculitis associated with renal failure. A case of Selye’s calciphylaxis in man. J Am Acad Dermatol. 1982; 6 (4 Pt 1): 537-539.

  39. Mohammed IA, Sekar V, Bubtana AJ, Mitra S, Hutchison AJ. Proximal calciphylaxis treated with calcimimetic “Cinacalcet”. Nephrol Dial Transplant. 2008; 23: 387-389 .

  40. Fine A, Zacharias J. Calciphylaxis is usually non-ulcerating: risk factors, outcome and therapy. Kidney Int. 2002; 61 (6): 2210-2217.

  41. Weenig RH, Sewell LD, Davis MD, McCarthy JT, Pittelkow MR. Calciphylaxis: natural history, risk factor analysis, and outcome. J Am Acad Dermatol 2007; 56: 569-79.

  42. Loidi L, Valcayo A, Oscoz S , Córboba A, Rodil R y Yanguas JI. Calcifilaxia. Estudio de 9 casos. Med Clin. 2016; 147 (4): 157-161.

  43. Rashid RM, Hauck M, Lasley M. Antinuclear antibody: a potential predictor of calciphylaxis in non-dialysis patients. J Eur Acad Dermatol Venereol. 2008; 22 (10): 1247-1248.

  44. Mochel MC, Arakari RY, Wang G, Kroshinsky D, Hoang MP. Cutaneous calciphylaxis: a retrospective histopathologic evaluation. Am J Dermatopathol. 2013; 35 (5): 582-586.

  45. García-Lozano JA, Ocampo-Candiani J, Martínez-Cabriales SA, Garza-Rodríguez V. An Update on Calciphylaxis. Am J Clin Dermatol. 2018; 19 (4): 599-608.

  46. Chen TY, Lehman JS, Gibson LE, Lohse CM, El-Azhary RA. Histopathology of calciphylaxis: cohort study with clinical correlations. Am J Dermatopathol. 2017; 39 (11): 795-802.

  47. Hayashi M, Takamatsu I, Yoshida T, Kanno Y, Sato Y, Abe T, Hashimoto A. Proposal of diagnostic criteria for calciphylaxis based on nationwide surveillance in Japan. J Jpn Soc Dial Ther. 2012; 45: 551-5517.

  48. Lal G, Nowell AG, Liao J, Sugg SL, Weigel RJ, Howe JR. Determinants of survival in patients with calciphylaxis: a multivariate analysis. Surgery. 2009; 146 (6): 1028-1034.

  49. Paul S, Rabito CA, Vedak P, Nigwekar SU, Kroshinsky D. The role of bone scintigraphy in the diagnosis of calciphylaxis. JAMA Dermatol. 2017; 153: 101-103.

  50. Shmidt E, Murthy NS, Knudsen JM, Weenig RH, Jacobs MA, Starnes AM et al. Net-like pattern of calcification on plain soft tissue radiographs in patients with calciphylaxis. J Am Acad Dermatol. 2012; 67: 1296-301.

  51. Rogers NM, Teubner DJO, Coates PTH. Calcific uremic arteriolopathy: advances in pathogenesis and treatment. Semin Dial. 2007; 20 (2): 150-157.

  52. McCarthy JT, El-Azhary RA, Patzelt MT, Weaver AL, Albright RC, Bridges AD et al. Survival, risk factors, and effect of treatment in 101 patients with calciphylaxis. Mayo Clin Proc. 2016; 91: 1384-1394

  53. An J, Devaney B, Ooi KY, Ford S, Fraw- ley G, Menahem S. Hyperbaric oxygen in the treatment of calciphylaxis: a case series and literature review. Nephrology (Carlton). 2015; 20: 444-4450.

  54. Vedvyas C, Winterfield LS, Vleugels RA. Calciphylaxis: a systematic review of existing and emerging therapies. J Am Acad Dermatol. 2012; 67 (6): e253-260.

  55. Cicone JS, Petronis JB, Embert CD, Spector DA. Successful treatment of calciphylaxis with intravenous sodium thiosulfate. Am J Kidney Dis. 2004; 43: 1104-1108.

  56. Strazzula L, Nigwekar SU, Steele D. Intralesional sodium thiosulfate for the treatment of calciphylaxis. JAMA Dermatol. 2013; 149: 946-949.

  57. Nigwekar SU, Brunelli SM, Meade D, Wang W, Hymes J, Lacson E. Sodium thiosulfate therapy for calcific uremic arteriolopathy. Clin J Am Soc Nephrol. 2013; 8: 1162-1170.

  58. Zitt E, König M, Vychytil A, Auinger M, Wallner M, Lingenhel G et al. Use of sodium thiosulphate in a multi-inter ventional setting for the treatment of calciphylaxis in dialysis patients. Nephrol Dial Transplant. 2013; 28: 1232-1240.

  59. Strazzula L, Nigwekar SU, Steele D, Tsiaras W, Sise M, Bis S et al. Intralesional sodium thiosulfate for the treatment of calciphylaxis. JAMA Dermatol. 2013; 149: 946-949.

  60. Phanish MK, Kallarackal G, Ravanan R, Lawson TM, Baboolal K. Tumoral calcinosis associated with pyrexia and systemic inflammatory response in a haemodialysis patient: successful treatment using intravenous pamidronate. Nephrol Dial Transplant. 2000; 15: 1691-1693.

  61. Shea MK, O’Donnell CJ, Hoffmann U, Dallal GE, Dawson-Hughes B, Ordovas JM et al. Vitamin K supplementation and progression of coronary artery calcium in older men and women. Am J Clin Nutr. 2009; 89: 1799-1807.

  62. El-Azhary RA, Patzelt MT, McBane RD, Weaver AL, Albright RC, Bridges AD. Calciphylaxis: a disease of pannicular thrombosis. Mayo Clin Proc. 2016; 91: 1395-1402.

  63. Sewell LD, Weenig RH, Davis MDP, McEvoy MT, Pittelkow MR. Low dose tissue plasminogen activator for calciphylaxis. Arch Dermatol. 2004; 140: 1043-1048.

  64. Floege J, Kubo Y, Floege A, Chertow GM, Parfrey PS. The effect of cinacalcet on calcific uremic arteriolopathy events in patients receiving hemodialysis: The EVOLVE Trial. Clin J Am Soc Nephrol. 2015; 10: 800-807.

  65. Girotto JA, Harmon JW, Ratner LE, Nichol TL, Wong L, Chen H. Parathyroidectomy promotes wound healing and prolongs survival in patients with calciphylaxis from secondary hyperparathyroidism. Surgery. 2001; 130: 645-50.

  66. Velasco N, MacGregor MS, Innes A, MacKay IG. Successful treatment of calciphylaxis with cinacalcet an alternative to parathyroidectomy? Nephrol Dial Transplant. 2006; 21: 1999-2004.

  67. Kang AS, McCarthy JT, Rowland C, Farley DR, van Heerden JA. Is calciphylaxis best treated surgically or medically? Surgery. 2000; 128: 967-971.

  68. Floege J, Kubo Y, Floege A, Chertow GM, Parfrey PS. The effect of cinacalcet on calciphylaxis events in haemodialysis patients in the EVOLVE Clinical Trial. Clin J Am Soc Nephrol. 2015 7; 10 (5): 800-807.

  69. Duffy A, Schurr M, Warner T, Chen H. Long-term outcomes in patients with calciphylaxis from hyperparathyroidism. Ann Surg Oncol. 2006; 13: 96-102.

  70. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003; 42: S1-201.




2020     |     www.medigraphic.com