title: Successful treatment of calciphylaxis with pamidronate.
abstract: Calciphylaxis is a complication of chronic kidney disease characterized by necrotic lesion in the skin. Histological examination reveals microcalcification of medium-sized blood vessels. We report on a 21-month-old girl with end-stage renal disease with severe calcium-phosphate imbalance. Calciphylaxis process started when she received calcium gluconate intravenously the day before the surgery to correct hypocalcemia and continued progressively despite peritoneal dialysis and forced stopping calcium-containing medication. Pamidronate, 0.5 mg/kg/d, was administered for 6 days and then once a week for 5 weeks. After 1 week, the skin lesion started to heal and circulation improved, and after 6 weeks, all skin lesions completely recovered. Pamidronate was effective to stop calciphylaxis in this case with advanced renal insufficiency and severe calcium-phosphate imbalance. Medical or surgical debridement are not suggested and lesions might recover without scar by pamidronate.
authors.affiliation: Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran. nhooman@iums.ac.ir.
authors.forename: Nakysa
authors.initials: N
authors.lastname: Hooman
authors.forename: Rama
authors.initials: R
authors.lastname: Naghshi-Zadiyan
authors.forename: Mitra
authors.initials: M
authors.lastname: Mehrazma
authors.forename: Fariba
authors.initials: F
authors.lastname: Jahangiri
mesh_terms: D001706:Biopsy; D002115:Calciphylaxis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D002125:Calcium Gluconate / Q000009:adverse effects*; D003646:Debridement; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000077268:Pamidronate; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D004164:Diphosphonates; D000077268:Pamidronate; D002125:Calcium Gluconate