Combination of sodium thiosulphate, cinacalcet, and paricalcitol in the treatment of calciphylaxis with hyperparathyroidism.

Abstract

Calciphylaxis (calcific uremic arteriolopathy) is a severe complication of hemodialysis characterized by subcutaneous calcification of the small arteries and tissue necrosis. Our case report is focused on a woman receiving hemodialysis (HD) with diabetes mellitus for 20 years and severe secondary hyperparathyroidism, who presented painful subcutaneous nodules, skin necrosis and ulcerations. As the treatment of calciphylaxis is mainly empirical and controversial, we decided to administer cinacalcet with paricalcitol for the control of hyperparathyroidism and sodium thiosulfate to improve the calcification of the arterioles. Two months after the start of the therapy, parathyroid hormone (PTH) decreased significantly and the skin lesions nearly disappeared. Thus, we believe that the combination of sodium thiosulfate with cinacalcet and paracalcitol is effective for the treatment of calciphylaxis with secondary hyperparathyroidism.

• Authors: I Kyritsis, A Gombou, I Griveas, I Agroyannis, K Retsa, B Agroyannis
• Journal: The International journal of artificial organs (Int J Artif Organs) Vol. 31 Issue 8 Pg. 742-4 (Aug 2008) ISSN: 0391-3988 [Print] United States
• PMID: 18825648 (Publication Type: Case Reports, Journal Article)

Chemical References

• Chelating Agents
• Ergocalciferols
• Naphthalenes
• Thiosulfates
• paricalcitol
• sodium thiosulfate
• Cinacalcet

Topics

• Aged
• Calciphylaxis (drug therapy, etiology, pathology)
• Chelating Agents (therapeutic use)
• Cinacalcet
• Drug Therapy, Combination
• Ergocalciferols (therapeutic use)
• Female
• Humans
• Hyperparathyroidism, Secondary (drug therapy, etiology, pathology)
• Naphthalenes (therapeutic use)
• Renal Dialysis (adverse effects)
• Thiosulfates (therapeutic use)
• Treatment Outcome