Evaluating the validity of subclassifying warfarin-associated nonuremic calciphylaxis: a retrospective cohort study

Int J Dermatol. 2018 May;57(5):572-574. doi: 10.1111/ijd.13884. Epub 2018 Jan 16.

Abstract

Background: Calciphylaxis is a devastating multifactorial disorder of the subcutaneous fat that is known to be associated with hypercoagulability. Recent literature has proposed subclassifying patients with calciphylaxis as having warfarin-associated or warfarin-unassociated disease.

Aim: We aimed to determine whether patients with warfarin-associated calciphylaxis differ clinically from patients with warfarin-unassociated calciphylaxis.

Materials and methods: We performed a subgroup analysis of patients with nonuremic calciphylaxis from a previously studied cohort and compared clinical and outcomes features of patients who were taking warfarin at the time of disease onset to those of patients who were not.

Results: Nineteen patients with nonuremic calciphylaxis were identified, including 10 (53%) who had been on warfarin at the time of disease onset and 9 (47%) who had not. Of all clinical and outcomes parameters tested, no significant differences were detected between the two groups.

Discussion and conclusions: Though this study is limited by its retrospective nature and the relatively small number of patients studied, available data do not support subclassifying patients with nonuremic calciphylaxis as having warfarin-associated or warfarin-unassociated disease. Rather, the body of literature would suggest that identification and correction of underlying disorders of hypercoagulability should be prioritized.

Publication types

  • Comparative Study
  • Evaluation Study
  • Validation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Calciphylaxis / chemically induced*
  • Calciphylaxis / classification*
  • Calciphylaxis / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Reference Values
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Thrombophilia / chemically induced
  • Thrombophilia / epidemiology
  • Thrombophilia / physiopathology
  • Warfarin / administration & dosage
  • Warfarin / adverse effects*

Substances

  • Anticoagulants
  • Warfarin