title: A case of cholesterol embolism confirmed by skin biopsy and successfully treated with statins and steroids.
abstract: Although cholesterol embolism syndrome was recognized as a clinicopathologic entity more than 50 years ago, it is attracting growing attention recently. It is a multisystemic disorder in which cholesterol crystals released from atherosclerotic plaques obstruct small arterioles, resulting in local ischemia and end-organ damage. There are no established treatments, and with the limited treatment options available, it is important to make the diagnosis as early as possible. We present the case of a 68-year-old man with cholesterol embolism who had a few fluttering atheromas in the aorta, as demonstrated by transesophageal ultrasonography. The diagnosis was confirmed by skin biopsy, and treatment with statins and steroids proved effective, as renal failure progressively improved. This case emphasizes the importance of early diagnosis and shows the possible therapeutic effects of statins and steroids for patients with this syndrome.
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Matsumura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Ohno
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.forename: Miki
authors.initials: M
authors.lastname: Ohta
authors.forename: Etsu
authors.initials: E
authors.lastname: Suzuki
authors.forename: Katsu
authors.initials: K
authors.lastname: Takenaka
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hirata
authors.forename: Toshiro
authors.initials: T
authors.lastname: Fujita
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D001706:Biopsy; D018438:Blue Toe Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D017700:Embolism, Cholesterol / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D019821:Simvastatin / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects / Q000473:pathology; D017445:Skin Diseases, Vascular / Q000175:diagnosis / Q000473:pathology*; D013256:Steroids / Q000627:therapeutic use*
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D013256:Steroids; D011239:Prednisolone; D000069059:Atorvastatin; D019821:Simvastatin