Topical treatment with 22-oxacalcitriol (OCT), a new vitamin D analogue, caused severe hypercalcemia with exacerbation of chronic renal failure in a psoriatic patient with diabetic nephropathy; a case report and analysis of the potential for hypercalcemia.
Vitamin D has been used for topical treatment of psoriasis, and 22-oxacalcitriol (OCT), shown to be less calcemic, was developed for the topical treatment of psoriasis in Japan. Recently, we treated a psoriatic patient with diabetic nephropathy who developed severe hypercalcemia with exacerbation of chronic renal failure by the use of topical OCT. Analysis of the reported cases demonstrated that both the severity of psoriasis and renal dysfunction are critical factors in the induction of hypercalcemia in the topical treatment of psoriasis. Therefore, we must pay attention to the severity of psoriasis, especially when complicated by renal function impairment. Regular monitoring of Ca and renal function is essential to avoid life-threatening hypercalcemia from the topical treatment with vitamin D analogues.
Ohigashi
Sawako
S
Department of Clinical Cell Biology (Second Department of Medicine), Chiba University Graduate School of Medicine, Chiba.
Tatsuno
Ichiro
I
Uchida
Daigaku
D
Higurashi
Mayumi
M
Hoshimoto
Saori
S
Seki
Naoto
N
Hashimoto
Natoake
N
Saito
Yasushi
Y
D002117:Calcitriol / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003928:Diabetic Nephropathies / Q000150:complications*; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D007676:Kidney Failure, Chronic / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*
D003879:Dermatologic Agents; D002117:Calcitriol; C051883:maxacalcitol