Pancreatitis associated with calciphylaxis successfully treated with sodium thiosulfate

Fig 1. Computed tomography of pancreas showing severe pancreatitis. INTRODUCTION Although pancreatitis is not uncommon, the underlying cause is usually identified from clinical history,physical examination, laboratory investigations, and radiologic imaging. Causes include alcohol, gallstones, medications, hypertriglyceridemia, and postendoscopic retrogradecholangiopancreatography. We report the case of a 54-year-old man with a history of renal failure who developed severe recurrent pancreatitis while on hemodialysis. No underlying cause for his pancreatitis could be identified, despite multiple investigations. He was later diagnosed with cutaneous calciphylaxis, and when this was successfully treated with sodium thiosulfate, his pancreatitis completely settled. Calciphylaxis is an ischemic vasculopathy, which can affect patients with end-stage renal disease. The skin findings are retiform purpura, stellate ulceration, and gangrene predominantly located on the lower legs. Calciphylaxis can affect internal organs; however, to the best of our knowledge, this is the first case report of calciphylaxis-associated pancreatitis.