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Calciphylaxis: a favorable outcome with hyperbaric oxygen
Vascular Medicine (London, England)
|October 31, 1998
Summary
Calciphylaxis, a rare condition causing skin ulcers in patients with kidney disease, can be effectively treated with hyperbaric oxygen therapy. This treatment significantly improved painful lower extremity ulcers in a patient with end-stage renal disease.
Area of Science:
- Nephrology
- Dermatology
- Vascular Medicine
Background:
- Calciphylaxis is a severe complication of end-stage renal disease (ESRD)
- It is characterized by painful skin necrosis and ulcerations
- Associated with abnormal calcium and phosphate metabolism
Observation:
- A 66-year-old female with diabetes mellitus and ESRD presented with painful livedo reticularis and necrotic lower extremity ulcers.
- Vascular studies showed intact pulses and normal large vessel perfusion.
- Laboratory findings revealed elevated calcium x phosphorous product and parathyroid hormone levels.
Findings:
- Biopsy confirmed medial calcinosis of small vessels, leading to a diagnosis of calciphylaxis.
- Standard treatments including wound debridement, antibiotics, and subtotal parathyroidectomy provided limited improvement.
- Hyperbaric oxygen therapy (HBOT) was initiated due to refractory symptoms.
Implications:
- Seven weeks of HBOT resulted in near-complete healing of the patient's calciphylaxis-related ulcers.
- This case highlights HBOT as a potential therapeutic option for calciphylaxis.
- Further research into HBOT's role in managing calciphylaxis is warranted.