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Sodium thiosulfate and pamidronate for treatment of calciphylaxis: case report
Cañabate, Sonia Fernández; Alvarez, Cristina Lucas; Valin, Luis Ortega & Ksabji, Jorge Estifan
Abstract
Introduction: Calciphylaxis is an infrequent disease that almost
exclusively affects patients with chronic kidney disease, although
cases have been observed in patients without renal function
impairment. The diagnosis is mainly made by clinical manifestations
and subsequently confirmed by radiological and histological study.
The optimal treatment is not known, although there is a consensus
that a multifactorial approach is required.
Clinical Case: A 68-year-old woman on hemodialysis for 2 years,
who presented a painful nodular lesion in the left thigh, a skin biopsy
was performed resulting in a diagnosis of calciphylaxis.
Treatment and Outcome: Treatment was started with intravenous
sodium thiosulfate. Pamidronate is added intravenously, three months
later, due to an unfavorable evolution. After 6 months of treatment,
improvement in nodular lesions and healing of the ulcerated lesion
was observed to be generally well tolerated treatment.
Conclusion: The combined treatment of sodium thiosulfate,
pamidronate and calcitomimetics has been effectiveand safe for the
treatment of calciphylaxis, inducing complete remission.
Keywords
Calciphylaxis; sodium thiosulfate; pamidronate; Hyperphosphatemia; Arterioles; Hypoalbuminemia Hyperparathyroidism
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