title: Calciphylaxis and sodium thiosulphate: a glimmer of hope in desperate situation.
abstract: BACKGROUND
  Calciphylaxis is an uncommon and often under diagnosed condition affecting patients undergoing chronic dialysis. Its pathogenesis is poorly understood. The abnormalities of calcium, phosphate and parathyroid hormone homeostasis leading to vascular calcification and ischaemic skin necrosis are thought to be the central problem. Meticulous wound care and aggressive metabolic control remain the cornerstone of the treatment; however, the overall benefit of these treatment options remains low and mortality and morbidity remain very high. Sodium thiosulphate is an inorganic salt, which is used for treating acute cyanide poisoning, recurrent calcium urolithiasis and nephrocalcinosis. Recently, it has also been reported to be useful in treating severe cases of calciphylaxis with promising results.
  
  
  METHODS
  A resistant case of calciphylaxis in a patient on long-term haemodialysis was treated with sodium thiosulphate (50 ml solution with 50% sodium thiosulphate) three times a week during the end of each dialysis session.
  
  
  RESULTS
  The skin lesions started to heal after two weeks and completely resolved after five months of treatment.
  
  
  CONCLUSIONS
  Sodium thiosulphate can be a safe and effective treatment option for resistant and severe cases of calciphylaxis.
authors.affiliation: Department of Nephrology, Dartford and Gravesham NHS Trust, Dartford, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Burnie
authors.forename: Sarah
authors.initials: S
authors.lastname: Smail
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Javaid
mesh_terms: D000368:Aged; D002115:Calciphylaxis / Q000188:drug therapy* / Q000209:etiology; D002614:Chelating Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D017445:Skin Diseases, Vascular / Q000188:drug therapy* / Q000209:etiology; D013885:Thiosulfates / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002614:Chelating Agents; D013885:Thiosulfates; C017717:sodium thiosulfate