title: Low-density lipoprotein apheresis for corticosteroid-resistant skin lesions caused by cholesterol crystal embolism: a case report and review of the literature.
abstract: Cholesterol crystal embolism (CCE) is an arterio-arterial embolism originating from the breakdown of atherosclerotic plaques in the aortic wall. The embolism affects the skin and kidney particularly, as well as frequently affects the gastrointestinal tract and other organs. Although there are no clearly effective direct therapies for CCE, corticosteroid therapy and combination therapy with low-density lipoprotein apheresis (LDL-A) followed by corticosteroids were recently reported to be effective for renal manifestations in some cases. However, few cases offer suggestions for the treatment of skin lesions caused by CCE. We report here a case of a 58-year-old man diagnosed with CCE with skin manifestations and kidney dysfunction who achieved complete remission after LDL-A. LDL-A may be a useful treatment for CCE, particularly in cases with skin manifestations.
authors.affiliation: Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Murata
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Furukawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Oikawa
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Okada
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001781:Blood Component Removal; D018438:Blue Toe Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008077:Lipoproteins, LDL; D008297:Male; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones; D008077:Lipoproteins, LDL
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