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Sodium thiosulfate: an emerging treatment for calciphylaxis in dialysis patients.

Yu Z, Gu L, Pang H, Fang Y, Yan H, Fang W - Case Rep Nephrol Dial (2015)

Bottom Line: Sodium thiosulfate (STS) was used for treatment in this case.The painful skin ulcers improved significantly soon after treatment, with a slight reduction in the calcium-phosphorus product.Total parathyroidectomy was carried out 6 months after the STS therapy, which successfully solved hyperparathyroidism and the high calcium-phosphorus profiles.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

ABSTRACT
Calciphylaxis is a rare but life-threatening complication seen in dialysis patients. We report a case with calciphylaxis and severe secondary hyperparathyroidism. Sodium thiosulfate (STS) was used for treatment in this case. The painful skin ulcers improved significantly soon after treatment, with a slight reduction in the calcium-phosphorus product. Total parathyroidectomy was carried out 6 months after the STS therapy, which successfully solved hyperparathyroidism and the high calcium-phosphorus profiles. Until now, no recurrence of calciphylaxis has been observed during the more than 7 years of follow-up. STS, as a chelating agent for calcium and iron, is an emerging treatment option for calciphylaxis; however, the mechanisms of STS in treating calciphylaxis are not clear. Our case demonstrates that STS treatment did not work through normalizing calcium-phosphorus profiles, although to optimize hyperparathyroidism and to control calcium and phosphorus levels is clearly part of the general treatment of calciphylaxis. The literature on STS treatment for calciphylaxis in dialysis patients was also reviewed.

No MeSH data available.


Related in: MedlinePlus

Calcium-phosphate (CaP) and iPTH levels.
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Figure 2: Calcium-phosphate (CaP) and iPTH levels.

Mentions: His iPTH level had been >900 pg/ml for >3 years beforehand, since the time he was on PD (fig. 2). He had been responsive to active vitamin D therapy at first, but treatment was stopped due to the high calcium and calcium-phosphorus product levels. The patient had already been on 1.25% calcium dialysate and on a calcium and phosphorus restriction diet. One of the parathyroid glands was found to be enlarged at an ultrasound scan. However, he underwent a parathyroidectomy operation due to his poor general condition.


Sodium thiosulfate: an emerging treatment for calciphylaxis in dialysis patients.

Yu Z, Gu L, Pang H, Fang Y, Yan H, Fang W - Case Rep Nephrol Dial (2015)

Calcium-phosphate (CaP) and iPTH levels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4386105&req=5

Figure 2: Calcium-phosphate (CaP) and iPTH levels.
Mentions: His iPTH level had been >900 pg/ml for >3 years beforehand, since the time he was on PD (fig. 2). He had been responsive to active vitamin D therapy at first, but treatment was stopped due to the high calcium and calcium-phosphorus product levels. The patient had already been on 1.25% calcium dialysate and on a calcium and phosphorus restriction diet. One of the parathyroid glands was found to be enlarged at an ultrasound scan. However, he underwent a parathyroidectomy operation due to his poor general condition.

Bottom Line: Sodium thiosulfate (STS) was used for treatment in this case.The painful skin ulcers improved significantly soon after treatment, with a slight reduction in the calcium-phosphorus product.Total parathyroidectomy was carried out 6 months after the STS therapy, which successfully solved hyperparathyroidism and the high calcium-phosphorus profiles.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

ABSTRACT
Calciphylaxis is a rare but life-threatening complication seen in dialysis patients. We report a case with calciphylaxis and severe secondary hyperparathyroidism. Sodium thiosulfate (STS) was used for treatment in this case. The painful skin ulcers improved significantly soon after treatment, with a slight reduction in the calcium-phosphorus product. Total parathyroidectomy was carried out 6 months after the STS therapy, which successfully solved hyperparathyroidism and the high calcium-phosphorus profiles. Until now, no recurrence of calciphylaxis has been observed during the more than 7 years of follow-up. STS, as a chelating agent for calcium and iron, is an emerging treatment option for calciphylaxis; however, the mechanisms of STS in treating calciphylaxis are not clear. Our case demonstrates that STS treatment did not work through normalizing calcium-phosphorus profiles, although to optimize hyperparathyroidism and to control calcium and phosphorus levels is clearly part of the general treatment of calciphylaxis. The literature on STS treatment for calciphylaxis in dialysis patients was also reviewed.

No MeSH data available.


Related in: MedlinePlus