[Medical treatment of cholesterol crystal embolism].
Cholesterol crystal embolization is an often fatal disorder in the elderly. Clinical manifestations consist of skin lesions arterial hypertension and renal failure. In some cases the clinical picture is suggestive of vasculitis. The most frequent predisposing factors are operative and radiological vascular procedures and the use of anticoagulants. The diagnosis can be confirmed by skin, muscle or kidney biopsy. Data concerning management are scarce and contradictory. A review of the literature has revealed some controversy as to how and when cholesterol crystal embolization should be treated, and controlled studies are lacking. We discuss the use of various drugs such as anticoagulants, antiplatelet agents and corticosteroids. In practice, the usual treatment is symptomatic and includes therapy of the peripheral vascular disease, adequate control of blood pressure and appropriate management of renal insufficiency. The most effective measure is prevention.
Hachulla
E
E
Service de Médecine interne, Hôpital Claude Huriez, Lille.
Devulder
B
B
D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000209:etiology; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002784:Cholesterol; D003460:Crystallization; D004617:Embolism / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012871:Skin Diseases / Q000188:drug therapy* / Q000209:etiology; D014665:Vasodilator Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D002784:Cholesterol
Traitement médical des embolies de cristaux de cholestérol.