Sodium thiosulphate treatment of uraemic tumoral calcinosis

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. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.