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Atheroembolic Renal Disease with Rapid Progression and Fatal Outcome

Overview
Publisher Springer
Specialty Nephrology
Date 2010 Nov 12
PMID 21069411
Citations 4
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Abstract

Atheroembolic renal disease is caused by foreign-body reaction to cholesterol crystals flushed from the atherosclerotic plaques into the small-vessel system of the kidneys. It is an underdiagnosed entity, mostly related to vascular procedures and/or anticoagulation, and prognosis is considered to be poor. Besides the benefit of aggressive medical prevention of further embolic events, use of steroid therapy has been associated with greater survival. Here we report a case of a patient with a multisystemic presentation of the disease days after performance of percutaneous coronary intervention and anticoagulation initiation due to an episode of myocardial infarction. Renal, cutaneous, ophthalmic, neurological, and possibly muscular and mesenteric involvement was diagnosed. Although medical treatment with corticosteroids and avoidance of further anticoagulation was applied, the patient rapidly progressed to end-stage renal disease requiring hemodialysis and died 6 months after diagnosis. This is a case of catastrophic progression of the disease resistant to therapeutic measures. Focus on diagnosis and more efficient preventive and therapeutic protocols are therefore needed.

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References
1.
Stabellini N, Cerretani D, Russo G, Rizzioli E, Gilli P . [Renal atheroembolic disease: evaluation of the efficacy of corticosteroid therapy]. G Ital Nefrol. 2002; 19(1):18-21. View

2.
Stabellini N, Rizzioli E, Trapassi M, Fabbian F, Catalano C, Gilli P . Renal cholesterol microembolism: is steroid therapy effective?. Nephron. 2000; 86(2):239-40. DOI: 10.1159/000045769. View

3.
Sijpkens Y, Westendorp R, van Kemenade F, van Duinen S, Breedveld F . Vasculitis due to cholesterol embolism. Am J Med. 1997; 102(3):302-3. DOI: 10.1016/s0002-9343(96)00379-8. View

4.
Fine M, Kapoor W, Falanga V . Cholesterol crystal embolization: a review of 221 cases in the English literature. Angiology. 1987; 38(10):769-84. DOI: 10.1177/000331978703801007. View

5.
Cogan E, Schandene L, Papadopoulos T, Crusiaux A, Goldman M . Interleukin-5 production by T lymphocytes in atheroembolic disease with hypereosinophilia. J Allergy Clin Immunol. 1995; 96(3):427-9. DOI: 10.1016/s0091-6749(95)70065-x. View