Sodium thiosulphate treatment of uraemic tumoral calcinosis

Rheumatology (Oxford). 2014 Mar;53(3):547-51. doi: 10.1093/rheumatology/ket388. Epub 2013 Nov 29.

Abstract

Objective: The objective of this study was to describe the efficacy of sodium thiosulphate (STS) in tumoral calcinosis (TC).

Methods: The methodology involved the reporting of four retrospective case reports of TC complicating end-stage renal disease (ESRD).

Results: We investigated STS treatment in four patients (two men; ages 46-70 years) with TC. ESRD was secondary to nephronophthisis (n = 1), membranoproliferative glomerulonephritis (n = 1), diabetic nephropathy (n = 1), and thrombotic microangiopathy (n = 1). TC developed 3-28 years after dialysis began and resulted in articular pain (n = 4) and stiffness (n = 1). It involved shoulders and hips and was diffuse in one patient. Several treatments were tried without success. STS 12.5-25 g was given intravenously after each dialysis session for 11-14 months. Pain and stiffness rapidly disappeared and TC showed partial or total regression. Side effects during infusion included increased blood pressure (n = 1), nausea (n = 1) and vomiting (n = 1). TC did not recur after treatment discontinuation with follow-up of 1.5-12 years.

Conclusion: STS showed promising efficacy in this short series of TC. Further studies are warranted.

Keywords: apatite; calcification; dialysis; renal failure; sodium thiosulphate; tumoral calcinosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Calcinosis / drug therapy*
  • Calcinosis / epidemiology*
  • Calcinosis / etiology
  • Comorbidity
  • Female
  • Humans
  • Hypertension / chemically induced
  • Hypertension / epidemiology
  • Incidence
  • Kidney Diseases / drug therapy*
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / etiology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Nausea / chemically induced
  • Nausea / epidemiology
  • Renal Dialysis
  • Retrospective Studies
  • Thiosulfates / adverse effects
  • Thiosulfates / therapeutic use*
  • Treatment Outcome
  • Uremia / drug therapy*
  • Uremia / epidemiology*
  • Vomiting / chemically induced
  • Vomiting / epidemiology

Substances

  • Thiosulfates
  • sodium thiosulfate