warfarin and Penile-Diseases

A man in his 30s, with a medical history of end-stage renal disease on haemodialysis three times a week after kidney transplant rejection, anaemia of inflammatory disease, hypertension, atrial fibrillation, hyperlipidaemia, subtotal parathyroidectomy and aortic valve replacement on Coumadin treatment, presented to our institution with glans penis pain. Examination of the penis revealed a painful black eschar with ulceration on the glans penis with surrounding erythema. CT scan of the abdomen and pelvis and penile Doppler ultrasound revealed calcifications of the abdominal, pelvic and penile blood vessels. He was diagnosed with penile calciphylaxis, a very rare manifestation of calciphylaxis characterised by penile blood vessel calcification leading to occlusion, ischaemia and necrosis. Treatment with low calcium dialysate and sodium thiosulfate was initiated with haemodialysis. Five days after the treatment started, the patient's symptoms improved.

Topics: Calciphylaxis; Humans; Kidney Failure, Chronic; Male; Penile Diseases; Penis; Renal Dialysis; Warfarin

Topics: Humans; Male; Middle Aged; Penile Diseases; Pulmonary Embolism; Streptokinase; Thrombosis; Warfarin

Topics: Adult; Antigens; Blood Proteins; Factor X; Female; Glycoproteins; Heterozygote; Humans; Male; Necrosis; Penile Diseases; Protein C; Skin Diseases; Vitamin K 1; Warfarin

Gangrene of the male external genitalia is an uncommon urologic problem with a limited differential diagnosis. To the etiologic spectrum we add warfarin-induced penile gangrene. Pathophysiology, diagnosis and treatment are discussed.

Topics: Adult; Humans; Male; Necrosis; Penile Diseases; Skin Diseases; Thrombophlebitis; Warfarin

Topics: Adult; Humans; Male; Necrosis; Penile Diseases; Skin; Warfarin