The Successful Treatment of Calciphylaxis with Sodium Thiosulfate and Hyperbaric Oxygen in a Non-dialyzed Patient with Chronic Kidney Disease

We present the case of a non-dialyzed patient with chronic kidney disease and biopsy-proven calciphylaxis who presented with painful cutaneous ulcers on both legs. The skin ulcers drastically improved within 6 months after the initiation of hemodialysis, aggressive wound care, the control of a miner...

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Bibliographic Details
Published in:Internal Medicine 2016/07/15, Vol.55(14), pp.1899-1905
Main Authors: Aihara, Seishi, Yamada, Shunsuke, Uchida, Yushi, Arase, Hokuto, Tsuchimoto, Akihiro, Nakano, Toshiaki, Taniguchi, Masatomo, Higashi, Harumichi, Kitazono, Takanari, Tsuruya, Kazuhiko
Format: Article
Language:English
Subjects:
alpha-2-HS-Glycoprotein - analysis
C-Reactive Protein
calciphylaxis
Calciphylaxis - complications
Calciphylaxis - therapy
calciprotein particle
chronic kidney disease
Female
Humans
hyperbaric oxygen therapy
Hyperbaric Oxygenation - methods
Middle Aged
Renal Dialysis - methods
Renal Insufficiency, Chronic - complications
Serum Albumin - analysis
Skin Ulcer - therapy
sodium thiosulfate
Thiosulfates - therapeutic use
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Summary:We present the case of a non-dialyzed patient with chronic kidney disease and biopsy-proven calciphylaxis who presented with painful cutaneous ulcers on both legs. The skin ulcers drastically improved within 6 months after the initiation of hemodialysis, aggressive wound care, the control of a mineral and bone disorder, and the administration of sodium thiosulfate and hyperbaric oxygen therapy. Notably, the patient's serum levels of C-reactive protein and calciprotein particles decreased and her serum albumin and fetuin-A levels increased in parallel with the alleviation of her calciphylaxis. This case highlights the importance of applying combined medical treatment to calciphylaxis and suggests the possible involvement of calciprotein particles in the pathogenesis of calciphylaxis.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.6326