Polyneuropathy associated with cholesterol crystal embolism.
BACKGROUND
Cholesterol crystal embolism complicating arterial catheterization usually presents as a multiorgan disease with renal failure, abdominal problems, and skin manifestations.


METHODS
We present a patient with hypertension and generalized arteriosclerosis who presented with muscle weakness, diffuse pain in the extremities, and renal failure 3 weeks after coronary catheterization and angioplasty of the right coronary artery. Muscle weakness progressed during the following months.


RESULTS
Nerve conduction studies and nerve biopsy showed severe axonal nerve injury. Biopsy of the kidney revealed the diagnosis of cholesterol crystal embolism.


CONCLUSIONS
The clinical presentation indicates a direct association of cholesterol crystal embolism and polyneuropathy. Although cholesterol crystal embolism represents a rare cause of polyneuropathy, it should be considered in patients with acute onset polyneuropathy and sudden onset multiorgan disease after arterial catheterization.
Department of Neurology, University Hospital Munich-Grosshadern, Ludwig-Maximilian University, Marchioninistr. 15, 81377, Munich, Germany. matthias.klein@med.uni-muenchen.de
Matthias
M
Klein
B
B
Hartmann
H J
HJ
Groene
T A
TA
Rupprecht
C
C
Schmidt
T
T
Pfefferkorn
A
A
Straube
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001012:Aorta, Abdominal; D001706:Biopsy; D003327:Coronary Disease / Q000628:therapy*; D003937:Diagnosis, Differential; D020833:Diffuse Axonal Injury / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D018450:Disease Progression; D017700:Embolism, Cholesterol / Q000150:complications*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D007668:Kidney / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011115:Polyneuropathies / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D012077:Renal Artery / Q000473:pathology; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D013497:Sural Nerve / Q000473:pathology