Calciphylaxis and subtotal parathyroidectomy: A double-edged sword

Madhavi Katikaneni, Lin Lwin, Hugo Villanueva, Jinil Yoo

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Calciphylaxis, also called calcific uremic arteriolopathy is a dreadful, life-threatening ischemic vasculopathy, primarily involving skin and subcutaneous tissue, mostly on patients with end-stage kidney disease. Calciphylaxis is a well-described, but still a poorly understood disorder of mineral metabolism. Its occurrence is rare, but increasingly reported. We describe a 62-year-old obese lady on hemodialysis for end-stage kidney disease due to type 2 diabetes, who developed two episodes of calciphylactic skin lesions during the 3 years observation. The healing of lesions in the first episode was prompted by a subtotal parathyroidectomy for severe secondary hyperparathyroidism. However, the resumption of oral calcium and vitamin D analog for the parathyroidectomy-related hypocalcemia induced another occurrence of widespread calciphylactic skin lesions in areas of great adiposity. The typical regimen of IV sodium thiosulfate brought a successful outcome to the second episode. Now, growing numbers of successful treatment for calciphylaxis are reported with more specific therapies and a clear understanding of the pathogenetic mechanism is in sight.

Original languageEnglish (US)
Pages (from-to)S33-S36
JournalHemodialysis International
Volume17
Issue numberSUPPL1
DOIs
StatePublished - Oct 1 2013

Keywords

  • Calciphylaxis
  • End stage kidney disease
  • Hemodialysis
  • Hypocalcemia
  • Parathyroidectomy
  • Sodium thiosulfate

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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