Abstract
Calciphylaxis is a serious form of vascular calcification that leads to skin necrosis with ulceration. It usually occurs in dialysis patients and carries very high morbidity and mortality rates. We present the case of a dialysis patient with biopsy-proven calciphylaxis of the lower extremity and severe secondary hyperparathyroidism, who had been receiving outpatient sodium thiosulfate, with no improvement. For management of the severe hyperparathyroidism, the patient underwent surgical excision of the parathyroid glands, leading to rapid correction of parathyroid hormone (PTH) levels and the concomitant calcium and phosphorus abnormalities. Subsequently, she was continued on outpatient sodium thiosulfate on dialysis days, and follow-up demonstrated progressive resolution of the skin lesion. We believe that in dialysis patients with significant secondary hyperparathyroidism and calciphylaxis, the combination of sodium thiosulfate with medical or surgical correction of the metabolic disorder should be considered as the first-line management approach along with pain control and optimal wound care.
| Original language | English |
|---|---|
| Pages (from-to) | 264-266 |
| Number of pages | 3 |
| Journal | Dialysis and Transplantation |
| Volume | 40 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2011 |
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ASJC Scopus subject areas
- Nephrology
- Transplantation
Cite this
Combined therapy with sodium thiosulfate and parathyroidectomy in a patient with calciphylaxis. / Castro, Hector; Cabeza-Rivera, Franco; Green, Dollie F.
In: Dialysis and Transplantation, Vol. 40, No. 6, 01.06.2011, p. 264-266.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Combined therapy with sodium thiosulfate and parathyroidectomy in a patient with calciphylaxis
AU - Castro, Hector
AU - Cabeza-Rivera, Franco
AU - Green, Dollie F
PY - 2011/6/1
Y1 - 2011/6/1
N2 - Calciphylaxis is a serious form of vascular calcification that leads to skin necrosis with ulceration. It usually occurs in dialysis patients and carries very high morbidity and mortality rates. We present the case of a dialysis patient with biopsy-proven calciphylaxis of the lower extremity and severe secondary hyperparathyroidism, who had been receiving outpatient sodium thiosulfate, with no improvement. For management of the severe hyperparathyroidism, the patient underwent surgical excision of the parathyroid glands, leading to rapid correction of parathyroid hormone (PTH) levels and the concomitant calcium and phosphorus abnormalities. Subsequently, she was continued on outpatient sodium thiosulfate on dialysis days, and follow-up demonstrated progressive resolution of the skin lesion. We believe that in dialysis patients with significant secondary hyperparathyroidism and calciphylaxis, the combination of sodium thiosulfate with medical or surgical correction of the metabolic disorder should be considered as the first-line management approach along with pain control and optimal wound care.
AB - Calciphylaxis is a serious form of vascular calcification that leads to skin necrosis with ulceration. It usually occurs in dialysis patients and carries very high morbidity and mortality rates. We present the case of a dialysis patient with biopsy-proven calciphylaxis of the lower extremity and severe secondary hyperparathyroidism, who had been receiving outpatient sodium thiosulfate, with no improvement. For management of the severe hyperparathyroidism, the patient underwent surgical excision of the parathyroid glands, leading to rapid correction of parathyroid hormone (PTH) levels and the concomitant calcium and phosphorus abnormalities. Subsequently, she was continued on outpatient sodium thiosulfate on dialysis days, and follow-up demonstrated progressive resolution of the skin lesion. We believe that in dialysis patients with significant secondary hyperparathyroidism and calciphylaxis, the combination of sodium thiosulfate with medical or surgical correction of the metabolic disorder should be considered as the first-line management approach along with pain control and optimal wound care.
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U2 - 10.1002/dat.20581
DO - 10.1002/dat.20581
M3 - Article
VL - 40
SP - 264
EP - 266
JO - Dialysis and Transplantation
JF - Dialysis and Transplantation
SN - 0090-2934
IS - 6
ER -