Meissner M, Bauer R, Beier C, Betz C, Wolter M, Kaufmann R, Gille J
Department of Dermatology, Johann Wolfgang Goethe University, Frankfurt, Germany.
Dermatology. 2006;212(4):373-6. doi: 10.1159/000092290.
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.
一名35岁依赖血液透析的慢性肾衰竭女性,大腿、臀部和腹部出现大面积、疼痛剧烈的坏死性溃疡及坏死,且有快速进展迹象。皮肤活检标本显示表皮广泛坏死,真皮血管血栓形成,血管壁内有局灶性钙沉积。此外,实验室检查结果显示血清钙和磷浓度乘积升高。因此,我们根据临床、生化和组织病理学标准诊断为钙化防御。我们启动了一项治疗方案,患者每周接受3次静脉注射硫代硫酸钠治疗。治疗2周后,已无新病灶可查,疼痛显著缓解。在接下来的4周内,可见溃疡逐渐缩小,个别组织缺损愈合。治疗开始4个月后,患者接受了成功的肾移植。因此,静脉注射硫代硫酸钠治疗钙化防御可能是治疗这种危及生命疾病的一种新的有效替代方法。