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Development of multiorganic calciphylaxis during teriparatide, vitamin D, and calcium treatment

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Abstract

Non-uremic calciphylaxis is a severe rare disorder characterized by ischemic necrosis. Recently, three cases of cutaneous calciphylaxis have been described in the context of teriparatide treatment. We present a 51-year-old woman with alcoholic cirrhosis who developed multiorganic calciphylaxis shortly after starting teriparatide treatment associated with calcium and 25-hydroxyvitamin D supplements for severe osteoporosis. After lengthy care of the infectious complications and treatment with bisphosphonates and sodium thiosulfate progressive improvement was observed over a 3-year period. The time between the initiation of teriparatide and the development of calciphylaxis suggests that this agent may have been the triggering factor of this process. Nevertheless, other non-negligible risk factors for calciphylaxis such as alcoholic liver disease, obesity, and vitamin D treatment must also be considered in this patient. Considering the severity of this extremely rare clinical condition, better knowledge of the risk factors related to calciphylaxis development is mandatory.

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Authors and Affiliations

  1. Department of Rheumatology, Hospital Clínic. CIBERehd, University of Barcelona, C/Villarroel 170, Barcelona, 08036, Spain

    A. Monegal, P. Peris & N. Guañabens

  2. Department Dermatology, Hospital Clínic. CIBERehd, University of Barcelona, Barcelona, Spain

    M. Alsina

  3. Department of Hepatology Unit, Hospital Clínic. CIBERehd, University of Barcelona, Barcelona, Spain

    J. Colmenero

Authors
  1. A. Monegal
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  2. P. Peris
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  3. M. Alsina
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  4. J. Colmenero
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  5. N. Guañabens
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Corresponding author

Correspondence to A. Monegal.

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Conflict of interest

Monegal A and Guañabens N have served on a scientific advisory board of Lilly. Pilar Peris, Merce Alsina, and Jordi Colmenero declare that they have no conflict of interest.

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Monegal, A., Peris, P., Alsina, M. et al. Development of multiorganic calciphylaxis during teriparatide, vitamin D, and calcium treatment. Osteoporos Int 27, 2631–2634 (2016). https://doi.org/10.1007/s00198-016-3571-1

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  • DOI: https://doi.org/10.1007/s00198-016-3571-1

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