Intractable wounds caused by calcific uremic arteriolopathy treated with bisphosphonates.

Abstract

BACKGROUND:

Calcific uremic arteriolopathy (calciphylaxis) is a calcification syndrome that predominantly affects relatively small vessels and is a life-threatening entity usually seen in patients with end-stage renal disease. Intractable skin necrosis sometimes causes lethal sepsis because it progresses rapidly as a result of mechanical stress.

OBJECTIVE:

We sought to investigate the efficacy of etidronate disodium (bisphosphonates) in treating intractable ulcers occurred in a patient on hemodialysis accompanied with calcific uremic arteriolopathy.

METHODS AND RESULTS:

A 53-year-old patient receiving hemodialysis with chronic renal failure accompanied with calciphylaxis had bilateral leg ulcers caused by minor trauma. The aggressive debridement worsened his skin condition as is usually seen in pyoderma gangrenosum. It eventually healed by lowering calcium-phosphorus levels with the administration of bisphosphonates and with the continuous use of sevelamer hydrochloride.

LIMITATIONS:

This study reporting a single case limits the interpretation of results.

CONCLUSION:

Bisphosphonates may be effective in treating calciphylaxis and arteriosclerosis obliterans by reducing the formation of ectopic calcification around blood vessels.

• Authors: Takaaki Hanafusa, Yuji Yamaguchi, Mamori Tani, Noriko Umegaki, Yukari Nishimura, Ichiro Katayama
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 57 Issue 6 Pg. 1021-5 (Dec 2007) ISSN: 1097-6787 [Electronic] United States
• PMID: 18021849 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Etidronic Acid

Topics

• Calciphylaxis (drug therapy, etiology)
• Etidronic Acid (therapeutic use)
• Humans
• Kidney Failure, Chronic (complications)
• Male
• Middle Aged
• Renal Dialysis
• Skin Ulcer (drug therapy, etiology)
• Treatment Outcome