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Case Reports
. 2025 Jul 1;4(3):138462.
doi: 10.56305/001c.138462. eCollection 2025.

Warfarin Induced Non-Uremic Calciphylaxis

Michael Kanan  1 , Farzana Hoque  2
Affiliations
Case Reports

Warfarin Induced Non-Uremic Calciphylaxis

Michael Kanan et al. J Brown Hosp Med. .

Abstract

Calciphylaxis is a rare and life-threatening condition characterized by vascular calcification and thrombosis, typically seen in patients with end-stage renal disease but also associated with long-term warfarin use in non-uremic patients. We present the case of a 78-year-old woman with a mechanical aortic valve on chronic warfarin therapy who developed progressive, painful necrotic skin ulcerations over ten months. Skin biopsy confirmed warfarin-induced non-uremic calciphylaxis. Following shared decision-making, warfarin was discontinued and replaced with low molecular weight heparin, and intravenous sodium thiosulfate was initiated. This case underscores the importance of recognizing non-uremic calciphylaxis in warfarin-treated patients and highlights the need for early diagnosis, multidisciplinary management, and shared decision-making to balance the risks of anticoagulation against serious complications like calciphylaxis.

Keywords: Calciphylaxis; non-uremic calciphylaxis; shared decision making; warfarin; warfarin induced skin necrosis.

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Conflict of interest statement

The authors declare they have no conflicts of interest

Figures

Figure 1.
Figure 1.. Multiple irregular black eschars with peripheral erythematous halos distributed across both thighs on admission.
Figure 2.
Figure 2.. Sharply demarcated black eschar with peripheral erythema in the left lower abdominal quadrant on admission.
See this image and copyright information in PMC

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