A propósito de un caso de lesiones cutáneas y calcifilaxis

espanolLa calcifilaxis es una inusual complicacion de la insuficiencia renal cronica aso- ciada a una elevada morbi-mortalidad. El caso clinico que presentamos, describe una paciente paratiroidectomizada en 1997, que en abril de 1999 es diagnosti- cada de calcifilaxis tras sospecha clinica y confirmacion mediante biopsia cuta- nea. La persistencia de niveles de PTH superiores a 400 pg/mI, junto con unas imagenes gammagraficas sospechosas de nodulos paratiroideos, determinan una nueva intervencion quirurgica (extirpandose dos nodulos), tras la cual, remite por completo la sintomatologia, a pesar de que los nodulos extraidos fueron identifi- cados como tejido tiroideo. Corroboramos el hecho de que la patogenia de la calcifilaxis es multifactorial, adquiriendo especial relevancia el uso de quelantes calcicos (con un riesgo elevado de presentar hipercalcemia) en el tratamiento de la insuficiencia renal cronica. EnglishCalciphylaxis is an unusual complication of chronic renal failure associted with increased morbidity and mortality. This presentation is a clinical case describing a patient parathyreidectomized in 1997, followed by the condition was clinically suspected and then confirmed by skin biopsy. PTHi levels above 400 pg/ml to- gether with scintigraphyc images suggesting parathyroid nodules resulted in the decision to try a new surgical procedure, which yielded two nodules of thyroi- deal tissue. After the surgery and in spite of this pathology result, the patient re- covered completely from her symptoms. This corroborates the theory that the etio- logy of calciphylaxis is multifactorial, acquiring special relevance the use of calcium-containing phospathe binders (representing a high risk of hypercalcemia) in the treatment of Chronic Renal Disease.