Naslov
Healing of skin necrosis and regression of anticardiolipin antibodies achived by parathyroidectomy in a dialysed female patient with calcific uremic arteriolopathy

Autori
Šefer, Siniša ; Trotić, Robert ; Degoricija, Vesna ; Vrsalović, Mislav ; Retković Gusić, Iva ; Kes, Petar

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Programme and Abstracts from 29th European Symposium on Calcified Tissues / Vukičević, Slobodan - New York (NY) : Springer, 2002, 271-272

Skup
29th European Symposium on Calcified Tissues

Mjesto i datum
Zagreb, Hrvatska, 25.05.2002. - 29.05.2002

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
skin necrosis ; anticardiolipin antibodies ; parathyroid hormone ; uremia

Sažetak
Aim: to present the impact of parathyroidectomy on the spontaneous healing of necrotic lesions of the skin of the lower leg and on anticardiolipin antibodies regression in a 68- years-old female dialysed patient with hyperparathyroidism and calcific-uremic arteriolopathy (CUA). Methods: After the occurrence of initial lesions of the lower leg skin, the intact parathyroid (iPTH) level, calcium (Ca) and phosphorus (P)product were measured, and on two occasions at 6 weeks intervals, the titer of anticardiolipin antibodies was determind, followed by a clinical monitoring of the progress of necrotic skin lesions. Two months after the occurrence of skin lesions, the patients right leg was amputated below the knee due to gangrene, and a histopathological analysis of the bioptic skin tissue of the amputated lower leg was made. After parathyroidectomy, iPTH, Ca, and P product were measured, and on two occasions at 6 weeks intervals, anticardiolipin antibodies titer was determined. Results: Before parathyroidectomy, an increased iPTH level, Ca and P product as well as on two occasions at 6 weeks intervals an elevated IgG anticardiolipin antibodies titer were determined. The histopathological analysis of the bioptic skin tissue of the amputated right lower leg showed mural calcification of artery walls and a thrombotic occlusion of small arteries, arterioles and dermal capillaries involving epidermolysis. one week after parathyroidectomy, iPTHlevel, Ca and P product were within normal range. Two measurements at 6 weeks interval revealed no anticardiolipin antibodies. Eight weeks after parathyroidectomy, spontaneous healing of necrotic skin lesions of the left lower leg was observed. Conclusion: Regression of anticardiolipin antibodies, normalisation of Ca and P product, and healing of the skin lesions after parathyroidectomy pointed to the elevated PTH levels as a crucial factor in the pathogenesis of CUA.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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