Buprenorphine for Intractable Pain of Skin Ulcer Associated with Calcific Uremic Arteriolopathy (Calciphylaxis): A Case Report

Terumasa Noike; Nirou Kikuchi; Takuya Yanagida; Hiromichi Seki; Mai Shiohara; Atsushi Miura; Hiroaki Takagi

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Buprenorphine for Intractable Pain of Skin Ulcer Associated with Calcific Uremic Arteriolopathy (Calciphylaxis): A Case Report

VernacularTitle:Buprenorphine for Intractable Pain of Skin Ulcer Associated with Calcific Uremic Arteriolopathy (Calciphylaxis): A Case Report
Author: Terumasa NOIKE ¹ ; Nirou KIKUCHI ² ; Takuya YANAGIDA ³ ; Hiromichi SEKI ³ ; Mai SHIOHARA ⁴ ; Atsushi MIURA ² ; Hiroaki TAKAGI ²
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1. Department of Palliative Medicine, Aizawa Hospital
2. Palliative Care Team, Aizawa Hospital
3. Department of Plastic and Reconstructive Surgery, Aizawa Hospital
4. Department of Nephrology, Aizawa Hospital
Keywords: calcific uremic arteriolopathy; calciphylaxis; buprenorphine
From:Palliative Care Research 2018;13(1):63-68
CountryJapan
Language:Japanese
Abstract: Purpose: To describe a patient receiving maintenance hemodialysis complicated with calcific uremic arteriolopathy (calciphylaxis) in whom ulcer pain control was successfully achieved by buprenorphine. Case: A 75-year-old man was admitted due to intractable, extreme pain, which was accompanied by skin ulcers of the lower extremities. By a series of examinations including skin biopsy, the lesion was diagnosed to be calcific uremic arteriolopathy. The pain was not controllable with non-steroidal anti-inflammatory drugs and even by the nerve block. Buprenorphine, a partial agonist for the opioid receptor, markedly alleviated the mixed pain which was attenuated from Numerical Rating Scale (NRS) 10/10 to 0-2/10. Conclusion: Buprenorphine was very effective for the refractory pain control in a patient with skin ulcer due to calcific uremic arteriolopathy.