Case reportSuccessful treatment of calciphylaxis with intravenous sodium thiosulfate
Section snippets
Case report
A 69-year-old white woman with a medical history including coronary artery disease, renal calculi, obesity, osteoarthritis, Graves disease, osteoporosis, and a long history of hypertension presented in 1999 with renal disease due to by hypertension and chronic hydronephrosis caused by retained ureteral calculi. Renal failure progressed, and in April 2002 the patient was started on continuous ambulatory peritoneal dialysis (CAPD). Peritoneal dialysate Ca concentration was 3.5 mEq/L (mmol/L). She
Discussion
Our patient had debilitating calciphylactic lesions 4 months after beginning peritoneal dialysis. The clinical setting, patient characteristics, signs and symptoms, and progression of the lesions were all characteristic of calciphylaxis,3, 4, 9, 10 as were the x-ray4 and bone scan findings.4 Biopsy specimens of calciphylactic lesions show calcification and endovascular fibrosis of small subcutaneous arteries and arterioles, often associated with infarction of the adjacent subcutis and skin. We
Acknowledgements
The authors thank Patricia King, David Kurniawan, and Danielle Napoles, RN, for their assistance in preparing the manuscript and in helping care for the patient.
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