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[Hyperthyroidism-induced calciphylaxis: A case report].

Samuel Delma¹, Corinne Isnard-Bagnis¹, Gilbert Deray¹

¹Service de néphrologie, groupe hospitalier La Pitié-Salpêtrière, 75013 Paris, France.

Nephrologie & Therapeutique

|November 3, 2018

Summary

This summary is machine-generated.

Calciphylaxis (CUA) is a severe skin condition in dialysis patients. This case highlights successful treatment of severe lower limb CUA in a hemodialysis patient with Graves' disease using a multidisciplinary approach.

Keywords:

Calciphylaxie Calciphylaxis Dialyse Dialysis Fluindione Hypercalcemia Hypercalcémie Hyperthyroidism Hyperthyroïdie

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Area of Science:

Nephrology
Dermatology
Endocrinology

Background:

Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare and severe cutaneous disease affecting 1-4% of dialysis patients.
CUA involves calcification of small arteries and arterioles in the skin, leading to painful ulcerations.
Multiple factors can contribute to the occurrence of CUA.

Observation:

A 69-year-old obese hemodialysis patient presented with severe bilateral lower limb calciphylaxis.
The patient had a recent diagnosis of Graves' disease, complicated by hypercalcemia and cardiac arrhythmia.
Treatment involved vitamin K antagonist, necessitating careful management.

Findings:

A comprehensive, multidisciplinary therapeutic strategy was implemented, including daily hemodialysis, sodium thiosulfate, denosumab for hypercalcemia, hyperbaric oxygen therapy, and meshed skin autograft.
This intensive management resulted in complete healing of the severe calciphylaxis lesions.

Implications:

This case represents the first documented instance of calciphylaxis secondary to hyperthyroidism in a dialysis patient.
Effective management of CUA, particularly when associated with complex comorbidities like hyperthyroidism, requires a multidisciplinary approach.
Highlighting the critical role of integrated care in achieving positive clinical outcomes for patients with severe CUA.