Monegal A, Peris P, Alsina M, Colmenero J, Guañabens N
Department of Rheumatology, Hospital Clínic. CIBERehd, University of Barcelona, C/Villarroel 170, Barcelona, 08036, Spain.
Department Dermatology, Hospital Clínic. CIBERehd, University of Barcelona, Barcelona, Spain.
Osteoporos Int. 2016 Aug;27(8):2631-4. doi: 10.1007/s00198-016-3571-1. Epub 2016 Mar 24.
Non-uremic calciphylaxis is a severe rare disorder characterized by ischemic necrosis. Recently, three cases of cutaneous calciphylaxis have been described in the context of teriparatide treatment. We present a 51-year-old woman with alcoholic cirrhosis who developed multiorganic calciphylaxis shortly after starting teriparatide treatment associated with calcium and 25-hydroxyvitamin D supplements for severe osteoporosis. After lengthy care of the infectious complications and treatment with bisphosphonates and sodium thiosulfate progressive improvement was observed over a 3-year period. The time between the initiation of teriparatide and the development of calciphylaxis suggests that this agent may have been the triggering factor of this process. Nevertheless, other non-negligible risk factors for calciphylaxis such as alcoholic liver disease, obesity, and vitamin D treatment must also be considered in this patient. Considering the severity of this extremely rare clinical condition, better knowledge of the risk factors related to calciphylaxis development is mandatory.
非尿毒症性钙化防御是一种以缺血性坏死为特征的严重罕见疾病。最近，有三例皮肤钙化防御病例在特立帕肽治疗的背景下被描述。我们报告了一名51岁患有酒精性肝硬化的女性，在开始使用特立帕肽治疗并联合补充钙和25-羟基维生素D以治疗严重骨质疏松症后不久，发生了多器官钙化防御。在对感染性并发症进行长期护理并使用双膦酸盐和硫代硫酸钠治疗后，在3年的时间里观察到病情逐渐改善。从开始使用特立帕肽到发生钙化防御的时间表明，该药物可能是这一过程的触发因素。然而，在该患者中，其他不可忽视的钙化防御危险因素，如酒精性肝病、肥胖和维生素D治疗，也必须予以考虑。鉴于这种极其罕见的临床病症的严重性，必须更好地了解与钙化防御发生相关的危险因素。
