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Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin

Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare vascular calcific disease that is most often associated with renal dysfunction and warfarin, particularly end-stage renal disease (ESRD). This condition causes debilitatingly painful skin lesions, oftentimes plaques, throughout areas...

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Detalles Bibliográficos
Autores principales: Smith, Megan C, Gleaves, Evan, Singh, Aniruddha, Akbar, Muhammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085035/
https://www.ncbi.nlm.nih.gov/pubmed/33936903
http://dx.doi.org/10.7759/cureus.14196
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author Smith, Megan C
Gleaves, Evan
Singh, Aniruddha
Akbar, Muhammad
author_facet Smith, Megan C
Gleaves, Evan
Singh, Aniruddha
Akbar, Muhammad
author_sort Smith, Megan C
collection PubMed
description Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare vascular calcific disease that is most often associated with renal dysfunction and warfarin, particularly end-stage renal disease (ESRD). This condition causes debilitatingly painful skin lesions, oftentimes plaques, throughout areas of cutaneous and subcutaneous adiposity. The progression of these lesions to black eschar with ulceration is the hallmark of CUA. In this report, we present the case of a Caucasian female with a past medical history of nephrogenic systemic fibrosis (NSF), ESRD, and mechanical aortic and mitral valves, anticoagulated with warfarin, who developed CUA. In the setting of mechanical prosthetic valves, vitamin K antagonists (VKA) and aspirin are the only evidence-based antithrombotic therapies. This case presents challenging decision-making when managing anticoagulant therapy in the absence of applicable guidelines.
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spelling pubmed-80850352021-04-30 Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin Smith, Megan C Gleaves, Evan Singh, Aniruddha Akbar, Muhammad Cureus Cardiac/Thoracic/Vascular Surgery Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare vascular calcific disease that is most often associated with renal dysfunction and warfarin, particularly end-stage renal disease (ESRD). This condition causes debilitatingly painful skin lesions, oftentimes plaques, throughout areas of cutaneous and subcutaneous adiposity. The progression of these lesions to black eschar with ulceration is the hallmark of CUA. In this report, we present the case of a Caucasian female with a past medical history of nephrogenic systemic fibrosis (NSF), ESRD, and mechanical aortic and mitral valves, anticoagulated with warfarin, who developed CUA. In the setting of mechanical prosthetic valves, vitamin K antagonists (VKA) and aspirin are the only evidence-based antithrombotic therapies. This case presents challenging decision-making when managing anticoagulant therapy in the absence of applicable guidelines. Cureus 2021-03-30 /pmc/articles/PMC8085035/ /pubmed/33936903 http://dx.doi.org/10.7759/cureus.14196 Text en Copyright © 2021, Smith et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Smith, Megan C
Gleaves, Evan
Singh, Aniruddha
Akbar, Muhammad
Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin
title Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin
title_full Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin
title_fullStr Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin
title_full_unstemmed Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin
title_short Anticoagulation in a Patient With Mechanical Prosthetic Valves and Calcific Uremic Arteriolopathy on Warfarin
title_sort anticoagulation in a patient with mechanical prosthetic valves and calcific uremic arteriolopathy on warfarin
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085035/
https://www.ncbi.nlm.nih.gov/pubmed/33936903
http://dx.doi.org/10.7759/cureus.14196
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