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Livedo Reticularis, Ulcers, and Peripheral Gangrene: Cutaneous Manifestations of Primary Hyperoxaluria
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Type 1 primary hyperoxaluria is an autosomal recessive disease in which hepatic enzymatic deficiency of alanine-glyoxalate aminotransferase (AGT) causes the deposition of calcium oxalate crystals in tissues throughout the body. The disease usually presents in childhood, but scattered cases of adult-onset forms have also occurred.1-2 Most patients have recurrent urinary tract infections and nephrolithiasis. Patients present in the late stage with renal insufficiency that rapidly progresses to renal failure with subsequent peripheral vascular disease and dermatologic developments. We describe a patient who presented with late-onset renal failure but is unique in that she had minimal renal disease prior to the acute renal failure.
Report of a Case
A 39-year-old white woman with a history of 1 incident of nephrolithiasis at age 14 years presented in May 1998 with massive edema and acute renal failure that required permanent hemodialysis. Four months later, she developed mottled and pruritic purpura on both lower legs. The reticulate patches . . . [Full Text of this Article]
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