Warfarin Induced Non-Uremic Calciphylaxis.

Calciphylaxis is a rare and life-threatening condition characterized by vascular calcification and thrombosis, typically seen in patients with end-stage renal disease but also associated with long-term warfarin use in non-uremic patients. We present the case of a 78-year-old woman with a mechanical aortic valve on chronic warfarin therapy who developed progressive, painful necrotic skin ulcerations over ten months. Skin biopsy confirmed warfarin-induced non-uremic calciphylaxis. Following shared decision-making, warfarin was discontinued and replaced with low molecular weight heparin, and intravenous sodium thiosulfate was initiated. This case underscores the importance of recognizing non-uremic calciphylaxis in warfarin-treated patients and highlights the need for early diagnosis, multidisciplinary management, and shared decision-making to balance the risks of anticoagulation against serious complications like calciphylaxis.