SYSTEMIC LUPUS-ERYTHEMATOSUS - CALCIPHYLAXIS INDUCED CARDIOMYOPATHY

A 31-year-old woman with systemic lupus erythematosus (SLE), diabetes mellitus, and chronic renal failure developed digital ischemia, myocar dial dysfunction, abnormal ECG, and elevated CPK levels. Radiographic studies revealed calcification of the peripheral vasculature although coronary angiography was unremarkable. An endomyocardial biopsy demons trated intra and extracellular myocardial calcification without eviden ce of vasculitis or primary myocarditis. A diagnosis of calciphylaxis, as a result of secondary hyperparathyroidism, was made. This case dem onstrates that calciphylaxis can mimic the cardiovascular manifestatio ns of SLE. Early differentiation of these disparate diseases is import ant because treatment strategies employed in SLE may exacerbate calcip hylaxis.