JWOCN Editor Comment
Suspect Calciphylaxis? Consult the WOC Nurse
Mikel Gray, PhD, FNP, PNP, CUNP, CCCN, FAANP, FAAN
In a recent article published in the New England Journal of Medicine, Nigwekar, Thadhani, and Brandenburg (NEJM 2018; 378:1704-14); reviewed literature related to calciphylaxis. The reference list for their review was sparse and contained a large number of "pre-clinical" studies examining the pathophysiology of calciphylaxis, rather than reports of large trials outlining evidence-based diagnosis and treatments you might expect in this type of article. In my opinion, calciphylaxis is one of a surprisingly large number of conditions that are overlooked and undervalued as topics for clinical research or scholarly publication. I purposely avoid the term "orphan conditions) since these are confined to truly rare conditions, affecting less than 200,000 persons worldwide. In 2011 Dianne Feeser challenged conceptions that calciphylaxis is rare, or even uncommon. Her article went on to challenge WOC nurses to rethink popular beliefs related to calciphylaxis, and to engage in clinical investigations strengthening our understanding, assessment and management of this condition. Over the past year, 4 author groups have answered this challenge; in our January/February issue Dr. Deb Netsch reviewed evidence related to, and presented original cases studies, of patients with cutaneous calcinosis, a closely related disorder sometimes confused with calciphylaxis. In 2017 Mary Famorca, Debra Beauchaine, and Nancy Angulo, presented a case of peristomal calciphylaxis. In this issue, Richard Masoetsa describes case of calciphylaxis in a male with diabetes mellitus and stage 5 chronic kidney disease. In addition, Dr. Jacqueline Zillioux, Alexander Geisenhoff and colleague describe a case of penile calciphylaxis, a rare form of calciphylaxis, and describe options for its management. Collectively these article demonstrate our role as key players in the management of this surprisingly common but understudied condition.