title: Use of corticosteroids in the treatment of cholesterol crystal embolism after cardiac catheterization: a report of four Japanese cases.
abstract: Cholesterol crystal embolism (CCE) is a serious complication associated with invasive vascular procedures. The prognosis of the renal involvement type of CCE is very poor, and there is currently no established treatment, other than supportive therapy. We herein report four cases of CCE with severe atherosclerosis wherein the renal function progressively deteriorated after cardiac catheterization. In three of the four patients, low-dose corticosteroids (0.3 mg/kg/day) improved the renal function, whereas the fourth patient died from CCE of the digestive system. This report reviews the literature on CCE and discusses possible therapeutic options.
authors: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan. jun-m@clin.medic.mie-u.ac.jp
authors: Jun
authors: J
authors: Masuda
authors: Takashi
authors: T
authors: Tanigawa
authors: Shiro
authors: S
authors: Nakamori
authors: Toshiki
authors: T
authors: Sawai
authors: Tomohiro
authors: T
authors: Murata
authors: Eiji
authors: E
authors: Ishikawa
authors: Norikazu
authors: N
authors: Yamada
authors: Mashio
authors: M
authors: Nakamura
authors: Masaaki
authors: M
authors: Ito
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D000368:Aged; D001027:Aortography / Q000009:adverse effects; D006328:Cardiac Catheterization / Q000009:adverse effects*; D015897:Comorbidity; D017023:Coronary Angiography / Q000009:adverse effects; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D003460:Crystallization; D017700:Embolism, Cholesterol / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007422:Intestines / Q000098:blood supply; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply; D054068:Livedo Reticularis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D014034:Toes / Q000098:blood supply; D014859:Warfarin / Q000009:adverse effects
chemical_list: D014859:Warfarin; D011239:Prednisolone