Development of Proximal Calciphylaxis with Penile Involvement after Parathyroidectomy in a Patient on Hemodialysis

• Published in: Internal Medicine Vol. 43; no. 1; pp. 63 - 68
• Main Authors: OIKAWA, Shigeru, OSAJIMA, Akihiko, TAMURA, Masahito, MURATA, Kougi, YASUDA, Hiroshi, ANAI, Hirofumi, KABASHIMA, Narutoshi, MATSUSHIMA, Yoshiyuki, NAKAMOTO, Masahiko, NAKASHIMA, Yasuhide
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 2004; Japanese Society of Internal Medicine
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biopsy, Needle; Blood and lymphatic vessels; calciphylaxis; Calciphylaxis - etiology; Calciphylaxis - pathology; Cardiology. Vascular system; Disease Progression; Emergency and intensive care: renal failure. Dialysis management; Fatal Outcome; General aspects; hemodialysis patient; Humans; hyperbaric oxygen therapy; Hyperparathyroidism, Secondary - diagnosis; Hyperparathyroidism, Secondary - surgery; Immunohistochemistry; Intensive care medicine; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - therapy; Long-Term Care; low PTH; lung; Lung Diseases - diagnostic imaging; Lung Diseases - etiology; Male; Medical sciences; Miscellaneous; Parathyroidectomy - adverse effects; Parathyroidectomy - methods; Penile Diseases - diagnostic imaging; Penile Diseases - etiology; penis; Radiography; Radionuclide Imaging; Renal Dialysis - adverse effects; Renal Dialysis - methods; Risk Assessment; Human; Proximal; Hemodialysis; Lung; Hyperbaric oxygen; Parathyroidectomy; Medicine; Extrarenal dialysis; Parathormone; Calciphylaxis; Treatment; Penis; Surgery; Development
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.43.63

Elevated parathyroid hormone (PTH) levels and hyperphosphatemia are thought to be associated with the development of calciphylaxis. We report a patient on hemodialysis who developed proximal calciphylaxis with consistently low PTH levels after parathyroidectomy. A 31-year-old man was admitted to our hospital because of abdominal skin ulcerations. Calciphylaxis spread to the penis, and simultaneous progressive lung calcification was evident on chest X-ray, suggestive of pulmonary calciphylaxis on 99mTc-methylene disphosphonate scintigraphy. The patient died of respiratory failure despite intensive treatment including hyperbaric oxygen therapy. This is the first report of a patient on hemodialysis who developed calciphylaxis involving the penis after parathyroidectomy.