Sodium thiosulphate as a promising therapeutic option to treat calciphylaxis.
A 35-year-old haemodialysis-dependent woman with chronic renal failure developed large, very painful necrotic ulcers and necrosis on the thighs, buttocks and the abdomen with signs of fast progression. The skin biopsy specimens showed a broad necrosis of the epidermis and thrombosed dermal vessels with focal calcium deposits within the wall. In addition, laboratory findings presented an increased product of serum calcium and phosphate concentrations. Thus, we diagnosed calciphylaxis on the basis of clinical, biochemical and histopathological criteria. We initiated a therapy in which our patient was treated with intravenous sodium thiosulphate 3 times weekly. Already after 2 weeks of treatment, no new lesions were detectable and there was a dramatic pain relief. In the following 4 weeks, a successive decline of the ulcers and the healing of individual tissue defects could be seen. Four months after the start of the therapy, the patient underwent successful renal transplantation. Thus, the intravenous therapy of calciphylaxis with sodium thiosulphate might be a new effective alternative in the treatment of this life-threatening disease.
Meissner
M
M
Department of Dermatology, Johann Wolfgang Goethe University, Frankfurt, Germany. meissner.markus@gmx.de
Bauer
R
R
Beier
C
C
Betz
C
C
Wolter
M
M
Kaufmann
R
R
Gille
J
J
D000005:Abdomen; D000328:Adult; D001706:Biopsy; D002081:Buttocks; D002115:Calciphylaxis / Q000175:diagnosis / Q000188:drug therapy*; D002614:Chelating Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D009336:Necrosis / Q000188:drug therapy / Q000209:etiology; D006435:Renal Dialysis; D012867:Skin / Q000473:pathology*; D013848:Thigh; D013885:Thiosulfates / Q000627:therapeutic use; D016896:Treatment Outcome
D002614:Chelating Agents; D013885:Thiosulfates; C017717:sodium thiosulfate