J Goossens1, M Courbebaisse2, E Caudron3, C Bahans4, V Vacquerie5, J Melchior6, P Vergne Salle7, C Moesch8, M Daudon9, V Frocht9, P Richette1, Hang-Korng Ea10, V Guigonis11. 1. Service de rhumatologie, hôpital Lariboisière, centre Viggo Petersen, Paris, France. 2. AP-HP, Georges Pompidou European Hospital, Physiology Department, Paris Descartes University, and INSERM, Unit 1151, Paris, France. 3. AP-HP, Hôpital Européen Georges Pompidou, Department of Pharmacy, Paris, France; Lip(Sys), Chimie analytique pharmaceutique EA 4041, Univ. Paris Sud, Université Paris-Saclay, Chatenay Malabry, France. 4. Service de pédiatrie, Hopital de la Mère et de l'Enfant, Limoges, France. 5. Service de chirurgie pédiatrique, Hopital de la Mère et de l'Enfant, Limoges, France. 6. Service de Rhumatologie, Hopitaux de Brabois, Vandoeuvre les Nancy, France. 7. Service de Rhumatologie, Hôpital Dupuytren, Limoges, France. 8. Service de Pharmacologie-toxicologie, Hôpital Dupuytren, Limoges, France. 9. Service des explorations fonctionnelles, Hôpital Tenon, Paris, France. 10. Service de rhumatologie, hôpital Lariboisière, centre Viggo Petersen, Paris, France. Electronic address: korngea@yahoo.fr. 11. Service de pédiatrie, Hopital de la Mère et de l'Enfant, Limoges, France. Electronic address: v.guigonis@gmail.com.
Abstract
INTRODUCTION: Tumoral calcinosis (TC) is a difficult-to-treat complication that can occur during several diseases such as dermatomyositis or genetic hyperphosphatemia. It is a painful and disabling condition that can lead to local complications including joint mobility reduction, cutaneous ulceration and superinfection. For the largest lesions, the treatment relies essentially on surgery. Intravenous sodium thiosulfate (STS) is efficient to treat calciphylaxis in patients undergoing hemodialysis. Local injections of STS seem efficient in superficial calcifications. OBJECTIVE: To report the efficacy and safety of intra-lesional injections of STS in tumoral calcinosis. RESULTS: We report two cases of successful intra-lesional injections of STS. A 44-year-old woman, with a history of dermatomyositis, presenting large subcutaneous calcifications in the right elbow, and a 42-year-old man, with a history of familial tumoral calcinosis, presenting large intramuscular calcifications in the right buttock, received weekly intra-lesional of 1-3g STS injections for 12 and 21 months, respectively. In both cases, the treatment relieved pain and greatly reduced the tumoral calcinosis with a very significant functional improvement without specific adverse effects. In case 1, TC size decreased from 28.7*56.0mm at baseline to 21.5*30.6mm at M12 treatment (59% reduction). In case 2, TC reduced from 167.5*204.3mm at baseline to 86.2*85.2mm at M21 treatment (79% reduction). CONCLUSION: Local injection of STS could be a promising therapeutic strategy for large and deep TC lesions and could therefore be an alternative to surgery.
INTRODUCTION:Tumoral calcinosis (TC) is a difficult-to-treat complication that can occur during several diseases such as dermatomyositis or genetic hyperphosphatemia. It is a painful and disabling condition that can lead to local complications including joint mobility reduction, cutaneous ulceration and superinfection. For the largest lesions, the treatment relies essentially on surgery. Intravenous sodium thiosulfate (STS) is efficient to treat calciphylaxis in patients undergoing hemodialysis. Local injections of STS seem efficient in superficial calcifications. OBJECTIVE: To report the efficacy and safety of intra-lesional injections of STS in tumoral calcinosis. RESULTS: We report two cases of successful intra-lesional injections of STS. A 44-year-old woman, with a history of dermatomyositis, presenting large subcutaneous calcifications in the right elbow, and a 42-year-old man, with a history of familial tumoral calcinosis, presenting large intramuscular calcifications in the right buttock, received weekly intra-lesional of 1-3g STS injections for 12 and 21 months, respectively. In both cases, the treatment relieved pain and greatly reduced the tumoral calcinosis with a very significant functional improvement without specific adverse effects. In case 1, TC size decreased from 28.7*56.0mm at baseline to 21.5*30.6mm at M12 treatment (59% reduction). In case 2, TC reduced from 167.5*204.3mm at baseline to 86.2*85.2mm at M21 treatment (79% reduction). CONCLUSION: Local injection of STS could be a promising therapeutic strategy for large and deep TC lesions and could therefore be an alternative to surgery.
Authors: M Chakhtoura; M S Ramnitz; N Khoury; G Nemer; N Shabb; A Abchee; A Berberi; M Hourani; M Collins; S Ichikawa; G El Hajj Fuleihan Journal: Osteoporos Int Date: 2018-06-20 Impact factor: 4.507
Authors: Yang Sha; Kanglun Hong; Melvin Kang Ming Liew; Jing Li Lum; Raymond Chung Wen Wong Journal: BMC Oral Health Date: 2019-07-09 Impact factor: 2.757