Treatment of calcific uremic arteriolopathy with intravenous sodium thiosulfate

Authors

  • Alejo Bertera Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina
  • Julieta Tabar Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina
  • Pamela Díaz Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina
  • Sandra García Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina
  • Ítalo Aloise Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

Keywords:

calciphylaxis, calcific uremic arteriolopathy, ulcers, necrosis, sodium thiosulfate

Abstract

Calcific uremic arteriolopathy is a rare disease with cutaneous and systemic involvement characterized by retiform purpura in plaques and/or subcutaneous nodules with progression to ischemia and necrotic ulcers, due to the calcification of the tunica media of small and medium caliber arterioles. Sodium thiosulfate is the most recommended treatment due to its antioxidant, calcium chelating and analgesic effects. We report the case of a patient with this entity, with complete resolution of the lesions and rapid improvement of the pain with intravenous sodium thiosulfate.

Author Biographies

Alejo Bertera, Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

Chief Resident

Julieta Tabar, Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

Medical Dermatologist, Wound Healing

Pamela Díaz, Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

Medical Dermatologist

Sandra García, Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

Dermatopathologist

Ítalo Aloise, Trauma and Emergency Hospital Dr. Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

Head of the Dermatology Service

References

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II. Jeong HS, Dominguez AR. Calciphylaxis: Controversies in pathogenesis, diagnosis and treatment. Am J Med Sci2016;351:217-227.

III. Campoy MV, Ibañez MJ, Luna A, Matamoros E, et ál. Calcifilaxis. A propósito de tres casos. Arch Argent Dermatol 2014;64:219-224.

IV. García S, Gómez ML, Rojas Bilbao EA. Calcifilaxis en un paciente sometido a hemodiálisis. Factores de riesgo asociados y revisión bibliográfica. Arch Argent Dermatol 2002;52:239-244.

V. Bonchak JG, Park KK, Vethanayagamony T, Sheikh MM, et ál. Calciphylaxis: a case series and the role of radiology in diagnosis. Int J Dermatol 2016;55:275-279.

VI. Essex DW, Wynn SS, Jin DK. Late onset warfarin induced skin necrosis: case report and review of the literature. Am J Hematol 1998;57:233-237.

VII. Musso CG, Enz P, Vidal F, Gelman R, et ál. Oral sodium thiosulfate solution as a secondary preventive treatment for calciphylaxis in dialysis patients. Saudi J Kidney Dis Transpl 2008;19:820-821.

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Published

2018-12-21

Issue

Vol. 24 No. 4 (2018): October-December 2018

Section

Clinical Cases

License

Copyright (c) 2018 Argentine Society of Dermatolgy

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