144 Indian Journal of Nephrology | Volume 29 | Issue 2 | March-April 2019 biopsy core was inadequate and did not contain deeper dermis. Sestamibi parathyroid scintigraphy revealed left inferior… Click to show full abstract
144 Indian Journal of Nephrology | Volume 29 | Issue 2 | March-April 2019 biopsy core was inadequate and did not contain deeper dermis. Sestamibi parathyroid scintigraphy revealed left inferior and right superior parathyroid adenoma. The clinical presentation and investigations confirmed systemic polyarteritis nodosa with CUA. Sixty milligram of prednisolone was commenced along with intensive hemodialysis, sevelamer carbonate and cinacalcet. After 1 month of follow‐up, fever subsided, skin ulcers of toes healed, neuropathy improved on examination and intact PTH decreased to 843 IU/ml. However, gangrenous changes of two toes of left foot progressed and required amputation.
               
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