title: Fat embolism syndrome: an autopsy-proven case involving a patient on dialysis and systemic scleroderma.
abstract: A 66-year-old woman receiving continuous ambulatory peritoneal dialysis developed acute respiratory distress 12 hours after a fall. Blood gas analysis revealed hypoxia (PaO2 67.7 torr) and metabolic acidosis with an increased anion gap, consistent with lactic acidosis (lactate, 86.5 mg/dL; normal range, 4.0-16.0). Magnetic resonance imaging showed a lumbar vertebral body fracture. On the fourth hospital day, the patient died of multiorgan failure and disseminated intravascular coagulation. Postmortem studies revealed fat emboli in the systemic circulation, ie, fat embolism syndrome. Diagnosing fat embolism syndrome can be difficult in patients on dialysis or in those with collagen vascular or pulmonary diseases.
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Nahoko
authors: N
authors: Nishimura
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Shogo
authors: S
authors: Banno
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Yukihiro
authors: Y
authors: Kimura
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Sayaka
authors: S
authors: Maeda
authors: Department of Clinical Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Mizuki
authors: M
authors: Kobayashi
authors: Department of Clinical Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Kumi
authors: K
authors: Kawai
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Norihiro
authors: N
authors: Suga
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Keisuke
authors: K
authors: Suzuki
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Naoto
authors: N
authors: Miura
authors: Department of Clinical Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Toyoharu
authors: T
authors: Yokoi
authors: Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
authors: Hirokazu
authors: H
authors: Imai
keywords: A-aDO2; acute respiratory distress; diagnostic criteria; fat embolism syndrome; hypoxia; lactic acidosis