title: Late onset of cholesterol crystal embolism after thrombolysis for cerebral infarction.
abstract: A 73-year-old man was admitted to our hospital because of bilateral foot pain. He was treated with thrombolysis for cerebral infarction about 5 months ago. Anticoagulants had not been used because of hemorrhagic infarction. The pulses of bilateral pedal arteries were palpable, but cyanosis was present in the bilateral toes. Laboratory data indicated azotemia and eosinophilia. Magnetic resonance imaging revealed multiple plaques of the thoracic and abdominal aorta, one of which was ulcerated. Skin biopsy proved the diagnosis of cholesterol crystal embolism (CCE). Because no invasive vascular procedure was performed, we assumed that CCE in this patient was related to thrombolysis. We should be cautious for late onset of CCE after thrombolysis.
authors.affiliation: Division of Internal Medicine, Saiseikai Kanazawa Hospital. kotarooe316@yahoo.co.jp
authors.forename: Kotaro
authors.initials: K
authors.lastname: Oe
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
authors.forename: Akikatsu
authors.initials: A
authors.lastname: Nakashima
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Sato
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Konno
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use; D000792:Angiography / Q000379:methods; D001707:Biopsy, Needle; D002544:Cerebral Infarction / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D017700:Embolism, Cholesterol / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000009:adverse effects* / Q000379:methods; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use; D014034:Toes / Q000473:pathology* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D010959:Tissue Plasminogen Activator; D000527:Alprostadil