• Internal medicine · Dec 2024

    Case Reports

    Cholesterol Crystal Embolism: Autopsy-proven Gastrointestinal Lesions, Pancreatitis, and End-stage Kidney Disease Which Developed after Undergoing Selective Abdominal Angiography.

    • Naoki Yamamoto, Norihiko Sakai, Daichi Kaikoi, Daichi Yomogida, Sho Kajikawa, Takaaki Wada, Takahiro Yuasa, Hisayuki Ogura, Koichi Sato, Taro Miyagawa, Shinji Kitajima, Tadashi Toyama, Akinori Hara, Miho Shimizu, Takashi Wada, and Yasunori Iwata.
    • Department of Nephrology and Rheumatology, Kanazawa University, Japan.
    • Intern. Med. 2024 Dec 15; 63 (24): 332533313325-3331.

    AbstractA 78-year-old man with atherosclerosis was diagnosed with hepatocellular carcinoma by transfemoral angiography of the celiac and superior mesenteric arteries (SMA). After surgery, a serum examination revealed progressive renal failure with eosinophilia, leading to end-stage kidney disease, in addition to active gastric ulcers and pancreatitis. Cyanosis in the bilateral toes showed a cholesterol crystal embolism (CCE) in a skin biopsy. Autopsy revealed that CCE involved the arterioles of multiple organs, and its distribution was anatomically consistent with the vascular territories of the celiac artery and SMA. CCE should therefore be considered in patients presenting with multiple types of tissue damage in the vascular territories after angiography.

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