CALCINOSIS CUTIS, RENAL INSUFFICIENCY AND LOWMOLECULAR- WEIGHT CALCIUM-CONTAINING HEPARINS

Pedro Mendes-Bastos, Vasco Coelho-Macias, Rodrigo Carvalho, Adelaide Milheiro, Jorge Cardoso

Abstract


A 35-year old black woman was referred to a Dermatology appointment due to subcutaneous nodules located in the right paraumbilical region and right flank that had appeared 2 weeks before. Her medical history was relevant for renal insuficiency on hemodialysis and infection by the human immunodeficiency virus (HIV-1). On physical examination there were two well-defined subcutaneous nodules; upon palpation, these lesions had a hard consistency, were painful and not adherent to the deep planes. An incisional biopsy was performed and histopathological examination was consistent with the diagnostic hypothesis of calcinosis cutis. A careful review of all medication established a temporal relationship between the skin nodules and subcutaneous administration of nadroparin calcium in that location. The nodules resolved spontaneously within 2 months after stopping the nadroparin calcium subcutaneous injections. Calcinosis cutis due to subcutaneous administration of low-molecular-weight calcium-containing heparins is rare and it is assumed that an elevated calcium-phosphorus product may be decisive in its pathophysiology. It is generally self-limited, resolving spontaneously.


Keywords


Calcinosis; Nadroparin; Renal insufficiency; Skin diseases

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References


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DOI: http://dx.doi.org/10.29021/spdv.72.4.329

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