Renal cholesterol embolic disease effectively treated with steroid pulse therapy.
A 65-year-old man developed acute renal failure with eosinophilia two weeks after a coronary bypass operation and angiography. Renal biopsy revealed cholesterol crystal embolism (CCE) in glomeruli and arterioles. Low-dose corticosteroid therapy failed to recover the renal function; further deterioration of renal function and peripheral ischemic symptoms such as livedo reticularis and blue toes occurred. However, steroid pulse therapy successfully attenuated CCE-induced renal failure and eosinophilia. It is suggested that steroid pulse therapy might be effective to treat CCE-induced renal failure and eosinophilia could be a useful marker for activity of CCE.
Takahashi
Toshiyuki
T
First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata.
Konta
Tsuneo
T
Nishida
Wakako
W
Igarashi
Akira
A
Ichikawa
Kazunobu
K
Kubota
Isao
I
D000368:Aged; D017700:Embolism, Cholesterol / Q000188:drug therapy* / Q000473:pathology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy* / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug
D005938:Glucocorticoids; D011239:Prednisolone