Academic Journal
Topical Sodium Thiosulfate for the Treatment of Calciphylaxis: Case Report.
| Τίτλος: | Topical Sodium Thiosulfate for the Treatment of Calciphylaxis: Case Report. |
|---|---|
| Συγγραφείς: | Theivendran T; Department of Renal Medicine, Blacktown Hospital, Sydney, New South Wales, Australia.; Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.; School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.; Faculty of Health and Medicine, University of Sydney, Sydney, New South Wales, Australia., Vucak-Dzumhur M; Department of Renal Medicine, Blacktown Hospital, Sydney, New South Wales, Australia.; Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.; School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.; School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia., Lee VW; Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.; Westmead Applied Research Centre, the University of Sydney, Sydney, New South Wales, Australia.; Centre for Kidney Research, School of Public Health, the University of Sydney, Sydney, New South Wales, Australia., Kim J; Faculty of Health and Medicine, University of Sydney, Sydney, New South Wales, Australia.; Department of Tissue Pathology & Diagnostic Oncology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW Health Pathology, Sydney, New South Wales, Australia., Chau K; Department of Renal Medicine, Blacktown Hospital, Sydney, New South Wales, Australia.; School of Medicine, Western Sydney University, Sydney, New South Wales, Australia. |
| Πηγή: | Nephrology (Carlton, Vic.) [Nephrology (Carlton)] 2026 May; Vol. 31 (5), pp. e70214. |
| Τύπος έκδοσης: | Case Reports; Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Science Country of Publication: Australia NLM ID: 9615568 Publication Model: Print Cited Medium: Internet ISSN: 1440-1797 (Electronic) Linking ISSN: 13205358 NLM ISO Abbreviation: Nephrology (Carlton) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Carlton, Vic., Australia : Blackwell Science |
| Ιατρικοί όροι (MeSH): | Thiosulfates*/administration & dosage , Calciphylaxis*/drug therapy , Calciphylaxis*/etiology , Calciphylaxis*/diagnosis , Kidney Transplantation*/adverse effects, Humans ; Female ; Middle Aged ; Treatment Outcome ; Biopsy ; Administration, Cutaneous |
| Περίληψη: | Calciphylaxis is a rare syndrome of microvascular calcification and skin infarction, occurring most commonly in patients with kidney failure. Calciphylaxis carries a poor prognosis, and current treatment involves mitigating risk factors, wound care, and medical therapies such as intravenous sodium thiosulfate for calcium chelation. We present an innovative treatment approach of topical sodium thiosulfate soaked gauze successfully used to treat calciphylaxis of a 58-year-old female with renal transplant. She presented with a tender bruise over the posterior right calf, in the context of good graft function (serum creatinine 88 μmol/L), warfarin use for metallic mitral valve, and total parathyroidectomy. Ultrasound imaging highlighted extensive subcutaneous tissue calcification. A punch biopsy of the lesion confirmed calciphylaxis and revealed acute deep ulceration within necrotic debris and calcium deposits along dermal blood vessels. She was managed with cessation of calcitriol and warfarin (switch to enoxaparin with anti-factor Xa level monitoring), replacement of vitamin K2, analgesia, and diligent wound care and debridement. She had twice-weekly intravenous sodium thiosulfate without any improvement and was suspended at 16 weeks after developing central line bacteraemia. On routine deep tissue debridement, small hard calcium deposits resembling calcinosis were noted to superficialise. The decision was made to commence thrice-weekly applications of topical sodium thiosulfate, prepared as gauze soaked in sodium thiosulfate 25% 15 mL applied for approximately 15 min. The ulcer completely healed, pain resolved, and topical treatment was suspended after a total of 20 weeks. This case demonstrates successful treatment of calciphylaxis using topical gauze soaked in sodium thiosulfate without concurrent intravenous sodium thiosulfate. (© 2026 Asian Pacific Society of Nephrology.) |
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| Contributed Indexing: | Keywords: calciphylaxis; hypoparathyroidism; renal failure; topical sodium thiosulfate; warfarin |
| Substance Nomenclature: | 0 (Thiosulfates) HX1032V43M (sodium thiosulfate) |
| Entry Date(s): | Date Created: 20260509 Date Completed: 20260716 Latest Revision: 20260716 |
| Update Code: | 20260716 |
| DOI: | 10.1111/nep.70214 |
| PMID: | 42104624 |
| Βάση Δεδομένων: | MEDLINE |
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