WSI23-111-Case-13

WSI23-111-Case-13

Case #13 - The patient is a 58-year-old male with past medical history significant for chronic pancreatitis status post Whipple surgery, type I diabetes mellitus, end-stage renal disease on hemodialysis, coronary artery disease status post percutaneous coronary intervention, and significant vasculopathy status post left below-the-knee amputation, right above-the-knee amputation, and multiple finger amputations in the setting of chronic poor wound healing. He is not receiving coumadin. Relevant laboratory results: Creatinine 3.68 mg/dL (reference interval 0.6-1.50 mg/dL), calcium 6.2 mg/dL (reference interval 8.5-10.5 mg/dL), phosphate 7.1 mg/dL (reference interval 2.6-4.5 mg/dL), PTH 216 pg/mL (reference interval 10-60 pg/mL). On exam, he has multiple purpuric and necrotic lesions/wounds on the left lower extremity (see clinical photograph #13). A punch biopsy is performed.

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December 31, 1969 7:00:00 PM