Dr Archee Singh1, Dr Nikky Isbel2,3
1Metro North Kidney Health Services, Brisbane, Australia, 2Metro South Hospital and Health Services, Brisbane, Australia, 3University of Queensland, Brisbane, Australia
Biography:
Bio to come
Background:
Tumoral calcinosis is a rare but significant complication of mineral bone disorder (MBD) in patients with kidney failure, particularly those undergoing dialysis. The stated incidence is between 0.5% to 3% in patients on hemodialysis. The condition is characterized by the progressive deposition of calcium salts in soft tissues, leading to the formation of large, often painful masses. The management of tumoral calcinosis traditionally revolves around controlling phosphate levels and addressing underlying factors such as hyperparathyroidism2. In some cases, kidney transplantation has shown benefits in alleviating symptoms and promoting resolution of lesions 3. However, treatment options are limited for patients who have already undergone parathyroid surgery and are preparing for kidney transplantation.
Case report:
In this case report, we present the successful treatment of tumoral calciphylaxis with once-weekly intravenous sodium thiosulfate in a patient undergoing hemodialysis. This is on the background of a kidney transplant in 2020, which was complicated by severe rejection requiring transplant nephrectomy in 2021. The patient presented with progressively enlarging, indolent masses over both shoulders, hips, knees and feet which caused significant pain and disability.
A significant reduction in the size of tumoral calcinosis lesions was observed after one month of therapy, providing an alternative therapeutic approach for patients with limited options.
Conclusion:
This case highlights the successful use of sodium thiosulfate in the treatment of tumoral calcinosis, particularly in a patient with limited therapeutic options due to prior parathyroid surgery and ongoing dialysis. The significant reduction in lesion size after one month of treatment suggests that sodium thiosulfate may offer a promising alternative for managing this challenging condition in patients with advanced kidney disease and mineral bone disorder.