Intractable wounds caused by calcific uremic arteriolopathy treated with bisphosphonates

Takaaki Hanafusa, Yuji Yamaguchi, Mamori Tani, Noriko Umegaki, Yukari Nishimura, Ichiro Katayama

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: Calcific uremic arteriolopathy (calciphylaxis) is a calcification syndrome that predominantly affects relatively small vessels and is a life-threatening entity usually seen in patients with end-stage renal disease. Intractable skin necrosis sometimes causes lethal sepsis because it progresses rapidly as a result of mechanical stress. Objective: We sought to investigate the efficacy of etidronate disodium (bisphosphonates) in treating intractable ulcers occurred in a patient on hemodialysis accompanied with calcific uremic arteriolopathy. Methods and Results: A 53-year-old patient receiving hemodialysis with chronic renal failure accompanied with calciphylaxis had bilateral leg ulcers caused by minor trauma. The aggressive debridement worsened his skin condition as is usually seen in pyoderma gangrenosum. It eventually healed by lowering calcium-phosphorus levels with the administration of bisphosphonates and with the continuous use of sevelamer hydrochloride. Limitations: This study reporting a single case limits the interpretation of results. Conclusion: Bisphosphonates may be effective in treating calciphylaxis and arteriosclerosis obliterans by reducing the formation of ectopic calcification around blood vessels.

Original languageEnglish
Pages (from-to)1021-1025
Number of pages5
JournalJournal of the American Academy of Dermatology
Volume57
Issue number6
DOIs
Publication statusPublished - 2007 Dec
Externally publishedYes

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ASJC Scopus subject areas

  • Dermatology

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