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[医源性非尿毒症性钙化防御:一例报告]

[Iatrogenic non uremic calciphylaxis: A case report].

作者信息

Hamich Soumaya, Rakotoson Julien, Mazereeuw Martin, Tristani Hugo, Lavelle Olivier, Sanchez Michèle, Lagrange Brigitte

机构信息

Service de dermatologie, centre hospitalier Henri-Duffaut, 84000 Avignon, France; Service de dermatologie et de vénéréologie, CHU Ibn Sina, Université Mohamed V, 10100 Rabat, Maroc.

Service de rhumatologie-médecine interne, CHU Morafeno, 501 Toamasina, Madagascar.

出版信息

Nephrol Ther. 2020 Dec;16(7):431-436. doi: 10.1016/j.nephro.2020.09.002. Epub 2020 Nov 8.

Abstract

Calciphylaxis is a rare and severe condition, characterized by calcification and thrombosis of small vessels, mainly affecting the skin. It is most often described in patients with end-stage renal disease on dialysis. Rarer cases of non-uremic calciphylaxis are reported. The prognosis is grim and the treatment is not well codified. Sodium thiosulfate has been used for more than a decade in the treatment of uremic calciphylaxis and has been shown to be effective. Its use in non-uremic cases has been reported in a few rare observations. Rheopheresis is a technique very recently used as an adjuvant treatment in uremic calciphylaxis. We describe a case of non-uremic calciphylaxis in a patient with normal renal function and with calcium supplementation. Sodium thiosulfate was introduced, then discontinued due to the patient's poor tolerance for this treatment. Rheopheresis was then used and allowed the acceleration of healing process and a significant reduction in pain. These two treatments are promising, larger studies are needed to establish their effectiveness in non-uremic calciphylaxis.

摘要

钙过敏是一种罕见且严重的病症,其特征为小血管钙化和血栓形成,主要累及皮肤。它最常出现在接受透析的终末期肾病患者中。也有非尿毒症性钙过敏的罕见病例报道。其预后严峻,治疗方法尚无明确规范。硫代硫酸钠已用于治疗尿毒症性钙过敏十余年,且已证明有效。在一些罕见的观察中报道了其在非尿毒症病例中的应用。血液滤过是一种最近才被用作尿毒症性钙过敏辅助治疗的技术。我们描述了一例肾功能正常且补钙的患者发生非尿毒症性钙过敏的病例。使用了硫代硫酸钠,但因患者对该治疗耐受性差而停药。随后采用血液滤过,加速了愈合过程并显著减轻了疼痛。这两种治疗方法前景良好,但需要开展更大规模的研究来确定它们在非尿毒症性钙过敏中的有效性。

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