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Vascular Medicine
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Calciphylaxis: a favorable outcome with hyperbaric oxygen

Steven M Dean

Grant Wound Care Center®, Grant Hospital, Columbus, OH, USA

Howard Werman

Department of Emergency Medicine—Hyperbaric Oxygen Division, The Ohio State University College of Medicine and Public Health, Columbus, OH, USA

A 66-year-old female with diabetes mellitus and end-stage renal disease presented with painful bilateral lower extremity livedo reticularis and necrotic ulcerations. Her distal lower extremity pulses were intact and plethysmographic studies confirmed relatively normal large vessel arterial perfusion. Extensive laboratory analysis was remarkable for an elevated calcium x phosphorous product and parathyroid hormone level.

An ulcer biopsy revealed small vessel medial calcinosis, and calciphylaxis was subsequently diagnosed. Despite aggressive wound debridements, antibiotics and subtotal parathyroidectomy, her ulcers failed to improve significantly prompting a trial of hyperbaric oxygen therapy. After 7 weeks of hyperbaric treatments, her ulcers had essentially healed.

Key Words: calciphylaxis • hyperbaric oxygen • ulcerations

Vascular Medicine, Vol. 3, No. 2, 115-120 (1998)
DOI: 10.1177/1358836X9800300205
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