title: [Unusual cause of chronic iron-deficiency anemia and insulin resistance: cholesterol embolism].
abstract: BACKGROUND
  Cholesterol embolism disease (CED) is an extremely polymorphous clinical entity. Rare reports mention digestive or endocrine manifestations.
  
  
  METHODS
  A 73 year-old female patient developed CED disclosed by iron deficiency anemia with chronic digestive bleeding associated with major insulin resistance.
  
  
  CONCLUSIONS
  Solitary iron deficiency anemia as the inaugural sign of CED is exceptional. Rare reports in the literature suggest it is related to polymorphous nonspecific lesions (ulcers, pseudotumoral lesions...) leading to chronic bleeding. Careful histopathology study of the lesions of fragments of healthy mucosa provides the correct diagnosis showing biconcave and optically empty slits. Insulin resistance has not been reported although prior diabetes is often mentioned as a predisposing factor for atherosclerosis. In our case, the role of CED was not determined, but pancreatic or inflammatory involvement can be envisaged.
authors.affiliation: Service de Médecine Interne et de Nutrition, Hôpitaux Universitaires de Strasbourg.
authors.forename: S
authors.initials: S
authors.lastname: Vinzio
authors.forename: E
authors.initials: E
authors.lastname: Andrès
authors.forename: A E
authors.initials: AE
authors.lastname: Perrin
authors.forename: L
authors.initials: L
authors.lastname: Marcellin
authors.forename: B
authors.initials: B
authors.lastname: Goichot
authors.forename: J L
authors.initials: JL
authors.lastname: Schlienger
mesh_terms: D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D017700:Embolism, Cholesterol / Q000150:complications*; D005260:Female; D006801:Humans; D007333:Insulin Resistance
vernacular_title: Une cause inhabituelle d'anémie ferriprive chronique et d'insulino-résistance: la maladie des embolies de cholestérol.