Nadroparin-induced Calcinosis cutis in renal transplant recipients.
Low-molecular-weight heparins are routinely used to prevent deep venous thrombosis following renal transplantation in our department. We report 2 patients who developed tender erythematous subcutaneous nodules with induration, ulceration and necrosis at the site of subcutaneous administration of nadroparin. Both patients were renal transplant recipients with impaired graft function and high serum calcium-phosphate products. The diagnosis calcinosis cutis was confirmed by technetium-99m bone scan and by histological examination of biopsies. Both patients showed spontaneous recovery several weeks after discontinuation of nadroparin. Patients with chronic renal failure and hyperphosphatemia may be predisposed to develop calcinosis cutis. In addition, the role of the calcium content of nadroparin is discussed.
van Haren
F M
FM
Department of Internal Medicine, University Hospital Nijmegen St. Radboud, NL-6500 HB Nijmegen, The Netherlands. docfrank@wxs.nl
Ruiter
D J
DJ
Hilbrands
L B
LB
D000328:Adult; D001706:Biopsy; D002114:Calcinosis / Q000139:chemically induced* / Q000473:pathology; D002118:Calcium / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects; D008875:Middle Aged; D017762:Nadroparin / Q000008:administration & dosage / Q000009:adverse effects*; D012082:Renal Veins; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
D017762:Nadroparin; D002118:Calcium