Chronic Cholesterol Crystal Embolism with a Spontaneous Onset

A 74-year-old man was referred to our hospital because of hypertension, blue toe syndrome and an elevation of serum creatinine from 0.8 to 1.4 mg/dl for eleven months. He had no history of invasive vascular procedures. Atherosclerosis was initially suspected, but renal impairment was accelerated fol...

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Bibliographic Details
Published inInternal Medicine Vol. 46; no. 14; pp. 1123 - 1126
Main Authors Enomae, Mio, Takeda, Shin-ichi, Yoshimoto, Keiichi, Takagawa, Kiyoshi
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2007
Subjects
Aged
Arteriosclerosis Obliterans - diagnosis
cholesterol crystal embolism
Chronic Disease
chronic kidney disease
corticosteroid
Creatinine - blood
Diagnosis, Differential
Embolism, Cholesterol - complications
Embolism, Cholesterol - diagnosis
Embolism, Cholesterol - therapy
Humans
Hypertension - diagnosis
Hypertension - etiology
Hypertension - therapy
Kidney Diseases - blood
Kidney Diseases - etiology
Kidney Diseases - pathology
Kidney Diseases - therapy
LDL apheresis
Male
renal biopsy
Treatment Outcome
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Summary:A 74-year-old man was referred to our hospital because of hypertension, blue toe syndrome and an elevation of serum creatinine from 0.8 to 1.4 mg/dl for eleven months. He had no history of invasive vascular procedures. Atherosclerosis was initially suspected, but renal impairment was accelerated following anticoagulant therapy. A renal biopsy established the diagnosis of cholesterol crystal embolism. Withdrawal of anticoagulants and the combination therapy with LDL apheresis and corticosteroids led to stabilization of the renal function. In patients with risk factors for atherosclerosis, cholesterol crystal embolism should be included in the differential diagnosis of chronic kidney disease.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.46.0102