Subtotal parathyroidectomy: a possible treatment for calciphylaxis.
Calciphylaxis is a rare disorder in patients with chronic renal failure that is characterized by ischemic necrotic skin lesions. The prognosis is grave and mortality is high (80%). The precise mechanism of calciphylaxis is still unknown, but in addition to chronic renal failure, elevated parathyroid hormone levels appear to play a role. The role of parathyroidectomy in treating affected patients is questionable. In this article, we describe the case of a patient with chronic renal failure who developed rapidly progressive subcutaneous calcifications and ulcerations in the lower extremities. These lesions regressed following subtotal parathyroidectomy. We also review the literature on calciphylaxis, with a focus on treatment options.
Bahar
Gideon
G
Department of Otorhinolaryngology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Mimouni
Daniel
D
Feinmesser
Meora
M
David
Michael
M
Popovzer
Aharon
A
Feinmesser
Raphael
R
D001707:Biopsy, Needle; D002115:Calciphylaxis / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology / Q000601:surgery*; D007150:Immunohistochemistry; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D012883:Skin Ulcer / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome