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- Rieke Neuhoff, Carsten Bramlage, Elisabeth Gröne, Frank Strutz, Michael Koziolek, and Gerhard Anton Müller.
- Abteilung Nephrologie und Rheumatologie, Medizinische Klinik, Georg-August-Universität Göttingen, Göttingen, Germany.
- Med Klin. 2008 Aug 15; 103 (8): 598-601.
Case ReportA 69-year-old man was admitted to the authors' hospital with an increase of plasma creatinine from 1.4 up to 4.9 mg/dl within 4 months and the clinical complaints of painful purple toes, recurrent epistaxis and disturbances of equilibrium. His past medical history was remarkable for three transient ischemic attacks and the diagnosis of a metabolic syndrome. Magnetic resonance imaging showed vasculitis-like lesions in the brain. Eosinophilia and tubular proteinuria were detected. Renal insufficiency was caused by cholesterol crystal embolism, as shown both by skin and renal biopsy. Aortic plaques were identified as the putative source of cholesterol embolization.ConclusionIn case of rapidly progressive renal failure, cholesterol crystal embolism must be considered even without preceding angiography.
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