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Case Report
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| Is sodium thiosulfate a therapeutic option for non-uremic calciphylaxis? |
| Ashish Bhargava1, Vasavi Paidpally2, Pragati Bhargava2, Alexander Vonbank1,2,3 Christoph Mayr1 Edgar Meusburger1 Karl Lhotta1,2 |
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1Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Austria.
2Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria. 3Private University of the Principality of Liechtenstein, Triesen, Liechtenstein. |
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doi:10.5348/ijcri-2012-08-161-CR-8
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Address correspondence to: Alexander Vonbank Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch Carinagasse 47 A-6800 Feldkirch Austria Phone: 43 5522 303 2670 Fax: +43 5522 303 7506 Email: alexander.vonbank@lkhf.at |
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| How to cite this article: |
| Vonbank A, Mayr C, Meusburger E, Lhotta K. Is sodium thiosulfate a therapeutic option for non-uremic calciphylaxis? International Journal of Case Reports and Images 2012;3(8):27–30. |
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Abstract
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Introduction:
Non-uremic calciphylaxis, a rare disorder with high mortality, is associated with severe calcifications of the media of arterioles which cause vascular occlusion and tissue necrosis.
Case Report: A non-uremic calciphylaxis of the lower limb, possibly caused by coumarin therapy for atrial fibrillation. Treatment consisting of coumarin avoidance, vitamin K supplementation and thrice weekly infusion of 20 g of sodium thiosulfate for three weeks led to complete healing of the leg ulcers. Conclusion: Sodium thiosulfate produces a considerable sodium load and may induce a decrease in serum calcium, potassium and phosphate levels as well as an increase in the anion gap. We suggest that sodium thiosulfate is effective in the treatment of non-uremic calciphylaxis, but its use requires monitoring of electrolytes, acid-base and volume status. Based on previous studies of sodium thiosulfate pharmacokinetics in individuals with normal renal function, which showed rapid excretion by the kidneys, application as a slow infusion over several hours is recommended in order to enhance its efficacy and avoid unwanted side effects. | |
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Key Words:
Calciphylaxis, Sodium thiosulfate, Pharmacokinetics
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Author Contributions:
Alexander Vonbank – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Christoph Mayr – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Edgar Meusburger – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Karl Lhotta – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Alexander Vonbank et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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