{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:38:37Z","timestamp":1768433917521,"version":"3.49.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,5,5]],"date-time":"2018-05-05T00:00:00Z","timestamp":1525478400000},"content-version":"vor","delay-in-days":124,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis. In 2017, she developed painful, necrotic ulcers on both breasts, again due to calciphylaxis. She had no history of anticoagulants use but she did use prednisolone 5mg\/day. She received adequate wound care, pain medication, antibiotics and dialysis frequency was increased with an addition of sodium thiosulfate. A bilateral ablation was discussed but she decided to stop all treatment following pulmonary aspiration and passed away one week later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">C<\/jats:italic>\n                      alciphylaxis is a rare diagnosis that should be considered in patients with renal insufficiency developing painful patches of skin necrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A multidisciplinary treatment approach including hyperparathyroidectomy, modified hemodialysis and wound treatment is recommended. There is limited evidence for surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2018.04.035","type":"journal-article","created":{"date-parts":[[2018,5,7]],"date-time":"2018-05-07T13:20:13Z","timestamp":1525699213000},"page":"22-25","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Bilateral breast calciphylaxis in a patient who survived earlier extensive tissue necrosis 5 years previously"],"prefix":"10.1097","volume":"48","author":[{"given":"E.M.J.","family":"Verstappen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.J.G.","family":"Maaskant-Braat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.R.","family":"Scheltinga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-5-20260114","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jaad.2017.01.040","article-title":"Calciphylaxis: comparison of radiologic imaging and histopathology","volume":"77","author":"Halasz","year":"2017","journal-title":"J. Am. Acad. Dermatol"},{"key":"R2-5-20260114","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1016\/j.mayocp.2016.06.025","article-title":"Survival, risk factor, and effect of treatment in 101 patients with calciphylaxis","volume":"91","author":"McCarthy","year":"2016","journal-title":"Mayo Clin. Proc"},{"key":"R3-5-20260114","first-page":"38","article-title":"Calciphylaxis in a nondialysis patient treated with sodium thiosulfate and high dose of oxygen","volume":"5","author":"Sanguankeo","year":"2017","journal-title":"Clin. Nephrol. - Case Stud"},{"key":"R5-5-20260114","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1097\/RLU.0000000000001837","article-title":"Sodium thiosulfate in the treatment of lung and breast calciphylaxis: CT and bone scintigraphy findings","volume":"42","author":"Shen","year":"2017","journal-title":"Clin. Nucl. Med"},{"key":"R8-5-20260114","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/tbj.12632","article-title":"Calciphylaxis of the breast: a case report and literature review","volume":"22","author":"Hall","year":"2016","journal-title":"Breast J"},{"key":"R10-5-20260114","first-page":"1314","article-title":"Calciphylaxis in CKD and beyond. Nephrology, dialysis","volume":"27","author":"Brandenburg","year":"2012","journal-title":"Transplantation"},{"key":"R11-5-20260114","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.2215\/CJN.00530108","article-title":"Calciphylaxis from nonuremic causes: a systematic review","volume":"3","author":"Nigwekar","year":"2008","journal-title":"CJASN July"},{"key":"R12-5-20260114","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jccw.2015.08.002","article-title":"Calciphylaxis in patients with preserved kidney function","volume":"6","author":"Maroz","year":"2014","journal-title":"J. Am. Coll. Clin. Wound Specialists"},{"key":"R13-5-20260114","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1046\/j.1523-1755.2001.00803.x","article-title":"Risk factors and mortality associated with calciphylaxis in end-stage renal disease","volume":"60","author":"Mazhar","year":"2001","journal-title":"Kidney Int"},{"key":"R14-5-20260114","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1053\/j.ajkd.2015.01.034","article-title":"Calciphylaxis: risk factors, diagnosis, and treatment","volume":"66","author":"Nigwekar","year":"2015","journal-title":"Am. J. Kidney Dis"},{"key":"R15-5-20260114","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1093\/ndt\/gfs466","article-title":"Novel insights into osteogenesis and matrix remodelling associated with calcific uraemic arteriolopathy","volume":"28","author":"Kramann","year":"2013","journal-title":"Nephrol. Dial. Transplant"},{"key":"R16-5-20260114","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.2215\/CJN.09880912","article-title":"Sodium thiosulfate therapy for calci\u00dcc uremic arteriolopathy","volume":"8","author":"Nigwekar","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol"},{"key":"R17-5-20260114","first-page":"64","article-title":"The mysterious calciphylaxis: wounds with eschar \u2014 to debride or not to debride?","volume":"50","author":"Martin","year":"2004","journal-title":"Ostomy Wound Manage"},{"key":"R18-5-20260114","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1111\/j.1346-8138.2012.01510.x","article-title":"How should we manage multiple skin ulcers associated with calciphylaxis?","volume":"39","author":"Sato","year":"2012","journal-title":"J. Dermatology"},{"key":"R19-5-20260114","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/j.1524-4725.2009.01091.x","article-title":"Should we perform surgical debridement in calciphylaxis?","volume":"35","author":"Bechara","year":"2009","journal-title":"Dermatol. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261218301615?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261218301615?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01612930-201848000-00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:14:29Z","timestamp":1768396469000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01612930-201848000-00005"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":15,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2018.04.035","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2018,1]]}}}