Combined therapy with sodium thiosulfate and parathyroidectomy in a patient with calciphylaxis

Hector Castro, Franco Cabeza-Rivera, Dollie F Green

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)264-266
Number of pages3
JournalDialysis and Transplantation
Volume40
Issue number6
DOIs
StatePublished - Jun 1 2011

Fingerprint

Calciphylaxis
Parathyroidectomy
Dialysis
Secondary Hyperparathyroidism
Outpatients
Vascular Calcification
Skin
Parathyroid Glands
Hyperparathyroidism
Therapeutics
Parathyroid Hormone
Phosphorus
Lower Extremity
Necrosis
Calcium
Morbidity
Biopsy
Pain
Mortality
sodium thiosulfate

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 journalArticle

Castro, Hector ; Cabeza-Rivera, Franco ; Green, Dollie F. / Combined therapy with sodium thiosulfate and parathyroidectomy in a patient with calciphylaxis. In: Dialysis and Transplantation. 2011 ; Vol. 40, No. 6. pp. 264-266.
@article{54955238d1f84bc496febf1d57f93d30,
title = "Combined therapy with sodium thiosulfate and parathyroidectomy in a patient with calciphylaxis",
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.",
author = "Hector Castro and Franco Cabeza-Rivera and Green, {Dollie F}",
year = "2011",
month = "6",
day = "1",
doi = "10.1002/dat.20581",
language = "English",
volume = "40",
pages = "264--266",
journal = "Dialysis and Transplantation",
issn = "0090-2934",
publisher = "John Wiley and Sons Inc.",
number = "6",

}

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.

UR - http://www.scopus.com/inward/record.url?scp=79958111341&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958111341&partnerID=8YFLogxK

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 -