[Cholesterol embolism: report of one case].
We report a 72 year-old male, that after a coronary angiogram presented pain, reduced distal skin temperature of both limbs, cyanosis of toes with preserved peripheral pulses and a rapidly progressive renal failure. Afterwards, the patient suffered a sudden bilateral amblyopia and hematochezia. Cholesterol embolism was confirmed with a skin biopsy and fundoscopy. A colonoscopy showed a possible ischemic colitis. After six months of follow up, the patient lost the distal phalanges of three toes, and renal failure stabilized, with a serum creatinine of 2.5 mg/dl. The diagnosis of cholesterol embolism is often missed, but it has a one year mortality of 80% and the presence of renal failure is the main prognostic indicator. Other prognostic indicators are the presence of high blood pressure, previous renal failure and peripheral artery disease.
Dufrechou
Carlos
C
Clínica Médica 2, Facultad de Medicina, Universidad de la República Montevideo, Montevideo, Uruguay. jcb2002@adinet.com.uy
Cedrés
Santiago
S
Bruno
Lorena
L
Quintana
Marcela
M
Costa
Virginia
V
Bagattini
Juan Carlos
JC
D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D017700:Embolism, Cholesterol / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male