WSI23-111-Case-19

WSI23-111-Case-19

Case #19 - The patient is a 59-year-old female with history notable for atrial fibrillation on warfarin, type II diabetes mellitus complicated by end-stage renal disease requiring hemodialysis, and peripheral vascular disease with right above-the-knee amputation. She presents with gangrene of distal left lower extremity. Relevant laboratory results: Creatinine 2.96 mg/dL (reference interval 0.6-1.50 mg/dL), calcium 9.4 mg/dL (reference interval 8.5-10.5 mg/dL), phosphate 3.5 mg/dL (reference interval 2.6-4.5 mg/dL), PTH 39 pg/mL (reference interval 10-60 pg/mL). On exam, there is wet gangrene of the great toe (see clinical photograph #19). The digit is amputated, and the involved skin sampled for histologic evaluation.

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December 31, 1969 7:00:00 PM