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    88 results match your criteria Cutaneous Cholesterol Emboli

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    Occlusive Nonvasculitic Vasculopathy.
    Am J Dermatopathol 2017 Sep;39(9):637-662
    *Associate Staff of the Department of Dermatology, Department of Dermatology, Hospital Universitario de la Princesa, Universidad Autónoma, Madrid, Spain; †Associate Staff of the Department of Dermatology, Department of Dermatology, Fundación Jiménez Diaz, Universidad Autónoma, Madrid, Spain; ‡Director of Dermatopathology, Department of Dermatology, Hospital Clínico Universitario, Salamanca, Spain; §Director of Dermatopathology, Dermatopathology Research Unit, Medical University of Graz, Graz, Austria; ¶Director of Dermatopathology, Dermatopathologie Laboratory, Friedrichschafen, Germany; and ‖Chairman of the Department of Dermatology, Department of Dermatology, Hospital Clínico Universitario, Salamanca, Spain.
    We review the most characteristic clinical and histopathologic findings of the cutaneous manifestations of the occlusive nonvasculitic vasculopathic disorders. Clinically, most of these conditions are characterized by retiform purpura. Histopathologic findings consist of occlusion of the vessel lumina with no vasculitis. Read More

    Multisystem diseases affecting the skin and eye.
    Clin Dermatol 2016 Mar-Apr;34(2):214-41. Epub 2015 Nov 22.
    Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address:
    There exist a wide variety of multisystem diseases that can affect both the eyes and skin. The skin and eyes may be the initial sites affected, leading to a new diagnosis of a systemic illness, or severe skin and eye involvement can drive treatment for patients with multisystem disease. It is important for physicians to be aware of how to recognize and diagnose these conditions, to evaluate patients for extent of disease, and to initiate appropriate therapies to combat these potentially severe diseases. Read More

    Limited cutaneous pseudovasculitis: a mild variant of cholesterol emboli syndrome.
    Circulation 2015 Feb;131(5):514-5
    From Harvard Medical School, Boston, MA (O.A.O.); Harvard Combined Dermatology Residency Program, Boston, MA (K.W.M., D.S., V.E.N.); Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA (V.E.N.); and Departments of Dermatology (M.M.S., A.P.S.) and Pathology (M.P.H.), Massachusetts General Hospital, Boston.

    Lesson of the month 1: sudden onset postural livedo reticularis, cyanotic toes and multiorgan failure.
    Clin Med (Lond) 2014 Jun;14(3):314-5
    Department of Dermatology, School of Medicine, Acibadem University, Istanbul, Turkey
    Cholesterol embolisation syndrome (CES) is a rare but serious disease with high mortality caused by the formation of an embolus made up of cholesterol crystals from atherosclerotic plaques. Its clinical presentation is usually initially insidious and it often remains unrecognised because of its non-specific clinical presentation, which can cause delays in treatment and high mortality. The most common physical symptoms are cutaneous. Read More

    Clinical Neuropathology practice guide 3-2014: combined nerve and muscle biopsy in the diagnostic workup of neuropathy - the Bordeaux experience.
    Clin Neuropathol 2014 May-Jun;33(3):172-8
    Simultaneous combined superficial peroneal nerve and peroneous brevis muscle biopsy, via the same cutaneous incision, allows examination of several tissue specimens and significantly improves the diagnosis of systemic diseases with peripheral nerve involvement. Vasculitides are certainly the most frequently diagnosed on neuro-muscular biopsies, but this procedure is also well advised to asses a diagnosis of sarcoidosis or amyloidosis. More occasionally, combined nerve and muscle biopsy may reveal an unpredicted diagnosis of cholesterol embolism, intra-vascular lymphoma, or enables complementary diagnosis investigations on mitochondrial cytopathy or storage disease. Read More

    Cholestrol emboli syndrome: acute renal insufficiency after a procedure or a thrombolytic therapy or anticoagulant therapy.
    Indian J Surg 2013 Jun 7;75(Suppl 1):432-5. Epub 2012 Oct 7.
    Department of Nephrology, Apollo Hospital, Jubilee Hills, Hyderabad, India.
    Cholesterol emboli syndrome is due to dislodgment of cholesterol crystals from the atherosclerotic plaques lining the walls of major arteries resulting in an occlusion of small arteries. We describe a case of severe cutaneous and renal cholesterol emboli syndrome following coronary angiography showing our observation that this syndrome is often unrecognized or misdiagnosed and that a better evaluation of risks factors in patients undergoing invasive procedures could prevent this severe complication. Read More

    Cutaneous cholesterol embolization syndrome: A case report.
    Dermatol Online J 2012 Jul 15;18(7):10. Epub 2012 Jul 15.
    Department of Dermatology, Christian Medical College, Vellore, Tamilnadu, India.
    An 81-year-old woman with chronic kidney disease, systemic hypertension, and a large infra-renal abdominal aortic aneurysm, developed bilateral calf muscle pain, altered sensorium, and deterioration of renal function following endovascular aneurysmal repair. On the third post-operative day she developed symmetrical purpuric macules with erythematous margins on the gluteal region and bluish reticulated patches on the soles and tips of toes. This was followed by melena development on the seventh post-operative day. Read More

    [Cholesterol embolism syndrome: a rare, but severe complication in patients with atherosclerosis].
    Dtsch Med Wochenschr 2012 May 15;137(21):1130-4. Epub 2012 May 15.
    Klinik für Innere Medizin, St.-Antonius-Hospital Eschweiler.
    Cholesterol embolization is a serious complication of atherosclerosis. Mainly, vascular manipulations during endovascular procedures or vascular surgery can release cholesterol crystals from atheromatous plaques. About 20 % are spontaneous emboli without precipitating event. Read More

    Spontaneous cutaneous cholesterol crystal embolism with focal clinical symptomatology: report of a case in an unusual location with secondary histological changes reminiscent of atypical decubital fibroplasia.
    Am J Dermatopathol 2011 Oct;33(7):726-8
    Department of Clinical Dermatology, Ospedali Riuniti, Foggia, Italy.
    Cholesterol crystal embolization (CCE) is one of the many complications of atherosclerosis. CCE is usually an iatrogenic event occurring either after vascular surgery, usually aortic surgery, or invasive angiographic investigations or in the course of anticoagulant or thrombolytic therapy. More rarely, it occurs after trauma or even in the absence of any inciting cause. Read More

    Subcutaneous thrombotic vasculopathy syndrome: an ominous condition reminiscent of calciphylaxis: calciphylaxis sine calcifications?
    Am J Dermatopathol 2011 Dec;33(8):796-802
    Department of Pathology, Lahey Clinic, Burlington, MA 01805, USA.
    Ischemic skin necrosis can be a cause of severe morbidity and mortality. It can be due to a number of systemic conditions such as (1) thrombotic vasculopathy syndromes, (2) calciphylaxis, (3) septic or cholesterol emboli, and (4) cutaneous vasculitis. We present 3 patients with a clinicopathological syndrome consisting of ischemic skin necrosis associated with histological pattern of subcutaneous thrombotic vasculopathy-extensive microvascular thrombosis confined to small vessels and capillaries of the subcutaneous tissue. Read More

    Unusual causes of cutaneous ulceration.
    Surg Clin North Am 2010 Dec;90(6):1161-80
    Department of Dermatology, Roger Williams Medical Center, 50 Maude Street, Providence, RI 02908, USA
    Skin ulceration is a major source of morbidity and is often difficult to manage. Ulcers caused by an inflammatory cause or microvascular occlusion are particularly challenging in terms of diagnosis and treatment. The management of such ulcers requires careful assessment of associated systemic conditions and a thorough analysis of the ulcer's clinical and histologic findings. Read More

    Atheroembolic renal disease with rapid progression and fatal outcome.
    Clin Exp Nephrol 2011 Feb 11;15(1):159-63. Epub 2010 Nov 11.
    Nephrology and Dialysis Unit, Hospital São Teotónio-Viseu, Av Rei Dom Duarte, 3504 509 Viseu, Portugal.
    Atheroembolic renal disease is caused by foreign-body reaction to cholesterol crystals flushed from the atherosclerotic plaques into the small-vessel system of the kidneys. It is an underdiagnosed entity, mostly related to vascular procedures and/or anticoagulation, and prognosis is considered to be poor. Besides the benefit of aggressive medical prevention of further embolic events, use of steroid therapy has been associated with greater survival. Read More

    [Severe renal insufficiency secondary to renal cholesterol emboli: therapeutical options revisited].
    Rev Med Suisse 2010 Mar;6(238):432-4, 436-7
    Service de néphrologie et consultation d'hypertension, Département de médecine interne, CHUV, 1011 Lausanne.
    Disseminated cholesterol crystal embolism is observed in elderly men with severe atherosclerosis. This syndrome may be triggered by arterial catheterizations, major vascular surgery, thrombolytic and/or anticoagulation treatment. Cutaneous signs, subacute renal insufficiency, a marked inflammatory syndrome and eosinophilia are common. Read More

    [Cholesterol crystal embolism and renal insufficiency: case report and literature review].
    Lijec Vjesn 2009 Sep-Oct;131(9-10):254-9
    Klinika za unutarnje bolesti, Klinicka bolnica Dubrava, Zagreb.
    Cholesterol crystal embolism with renal impairment is increasingly recognised as an iatrogenic complication of invasive vascular procedures. We present a 58-year-old patient in whom the presence of a classic triad of precipitating event (coronary angiography), subacute presentation of renal failure and cutaneous lesions (livedo reticularis and Blue Toe syndrome) suggested this entity. The confirmatory diagnosis was made by means of renal biopsy which revealed cholesterol crystals lodged in arteries. Read More

    Cutaneous cholesterol embolization.
    J Dermatol Case Rep 2009 Aug;3(2):27-9
    Department of Plastic and Reconstructive Surgery, Canakkale Onsekiz Mart University, Canakkale, Turkey.
    Background: Cutaneous cholesterol embolization syndrome occurs as a result of cholesterol embolization from atherosclerotic plaques lining the walls of arteries and arterioles. It can occur sporadically but is more commonly associated with iatrogenic manipulation via invasive vascular procedures or therapies (anticoagulation or thrombolytics) The three most common organ systems afflicted by cholesterol emboli include the kidneys, gastrointestinal system, and skin.

    Main Observations: We present two patients with cutaneous cholesterol embolization A 74-year-old with no prior disease or trauma was referred to the hospital with the acute chest pain. Read More

    Cutaneous reactive angiomatosis associated with cholesterol embolism.
    J Cutan Pathol 2010 Jun 10;37(6):692-6. Epub 2009 Jul 10.
    Department of Dermatology, Taipei Medical University Hospital, Taipei 110, Taiwan.
    Cholesterol embolism (CE) is characterized by emboli containing cholesterol crystal in the arterioles, most commonly found in the skin and the kidney. The skin presentations of CE include livedo reticularis, blue toe syndrome, ulceration and gangrene. Cutaneous reactive angiomatosis (CRA) is a recently proposed term to describe a group of reactive vascular proliferation in skin caused by various diseases. Read More

    Case Report: Atheroembolic renal disease in a 72-year-old patient through coronary intervention after myocardial infarction.
    Hemodial Int 2008 Oct;12(4):406-11
    Department of Medicine, Division of Nephrology, Würzburg, Germany.
    Cholesterol embolization or atheroembolic renal disease (AERD) is an often underdiagnosed issue in patients featuring a prevalent risk profile. It is a multisystemic disease with progressive renal insufficiency due to foreign body reaction of cholesterol crystals flushed into a small vessel system of the kidneys from the arteriosclerotic plaques. The most common setting in which it occurs is iatrogenic after vascular catheterization and less frequent spontaneously. Read More

    Cholesterol crystal embolization: a possible complication of peripheral endovascular interventions.
    J Endovasc Ther 2008 Oct;15(5):614-25
    Department of Clinical Biochemistry, Royal Free Hospital and Royal Free Medical School, University College, London, UK.
    Cholesterol crystal embolization (CCE) is a possible complication of peripheral endovascular interventions. The diagnosis of CCE is suggested by the gradual onset of peripheral cutaneous manifestations (e.g. Read More

    Atypical ischemic lower extremity ulcerations: a differential diagnosis.
    Vasc Med 2008 Feb;13(1):47-54
    Department of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio 43210, USA.
    Severe peripheral artery disease (PAD) is the predominant cause of ischemic ulcerations involving the lower extremities. PAD-associated ulcerations are typically distally located involving the feet, toes, and sometimes the calves. In contradistinction, atypical ischemic ulcerations of the lower extremity are often non-atherosclerotic in etiology, involve the proximal leg (thigh/buttocks), can evolve despite palpable distal pulses, and may coexist with other cutaneous aberrations (e. Read More

    Post-percutaneous coronary angioplasty atheroembolization--a feared iatrogenic complication.
    Rev Port Cardiol 2007 Sep;26(9):857-66
    Serviço de Medicina do Hospital São Francisco Xavier / Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
    Atheroembolic disease is a rarely recognized clinical entity. The growing use of antiplatelet and thrombolytic therapy and of invasive cardiovascular procedures in acute coronary syndromes has nevertheless transformed this feared iatrogenic complication into an increasingly frequent diagnosis. The authors review this entity through the case of a 71-year-old man who, fifteen days after undergoing thrombolysis for acute myocardial infarction with ST-segment elevation, followed by elective percutaneous coronary revascularization under triple antiplatelet therapy, came to the emergency department with a clinical setting of mental confusion, gastrointestinal bleeding, oliguria and cutaneous eruptions on the lower limbs; laboratory tests revealed severe azotemia and hyperkalemia. Read More

    Cutaneous pseudovasculitis.
    Am J Dermatopathol 2007 Feb;29(1):44-55
    Division of Dermatology, Albany Medical College, Albany, NY 12208, USA.
    Cutaneous pseudovasculitis represents a heterogeneous collection of disorders that are capable of simulating cutaneous vasculitis and can be broadly classified into diseases that produce hemorrhage (petechiae, purpura, and ecchymoses) or vessel occlusion with resultant livedo, cyanosis, ulcers, digital necrosis, and/or gangrene. Overlap is not uncommon, but if present, one mechanism dominates. Hemorrhagic pseudovasculitis is due to vessel wall dysfunction (incompetence), which can be related to diverse factors that include vessel wall deposition of metabolic substances (amyloid, calcium), nutritional deficiencies (scurvy), nonvasculitic inflammatory purpura (pigmented purpuric dermatitis, arthropod, viral and drug reactions), degeneration of the vessel wall and supporting stroma (senile/solar purpura), direct vessel wall invasion of infective organisms, coagulation-fibrinolytic disorders (eg, thrombocytopenia), and vessel wall trauma. Read More

    Clinical characteristics and outcomes of Chinese patients with cholesterol crystal embolism after coronary intervention.
    Clin Cardiol 2006 Nov;29(11):503-5
    Department of Cardiology, Peking University First Hospital, Beijing, PR China.
    Background: Cholesterol crystal embolism (CCE) is a complication of atherosclerosis. Vascular surgery, vascular angiography, and anticoagulation have been identified as inciting factors.

    Hypothesis: This paper sought to analyze the clinical characteristics of patients with CCE after percutaneous coronary intervention. Read More

    Facial cutaneous cholesterol embolism revealing a tight carotid stenosis: a case report.
    Eur J Vasc Endovasc Surg 2007 Jan 24;33(1):62-4. Epub 2006 Oct 24.
    Department of Vascular Surgery, Avicenne University Hospital, Rabat, Morocco.
    We report a case of systemic cholesterol embolisms (CE) with rare localization to the level of the face from a tight carotid stenosis. The case history is that of a 75 year old patient who presented with cholesterol embolisms in the territory of the external carotid artery. The patient underwent successful carotid endarterectomy with no postoperative neurological event. Read More

    Cholesterol embolism: still an unrecognized entity with a high mortality rate.
    J Am Acad Dermatol 2006 Nov 27;55(5):786-93. Epub 2006 Jun 27.
    Department of Dermatology, Hospital Universitari de Bellvitge, University of Barcelona, Spain.
    Background: Cholesterol embolism (CE) is an increasingly common but often underdiagnosed medical problem. The recognition of clinical manifestations of CE is the first step toward a correct diagnosis.

    Objective: Our aim was to characterize the features of CE and the risk factors for fatal outcome. Read More

    A case of skin necrosis as a result of cholesterol crystal embolisation.
    J Plast Reconstr Aesthet Surg 2006 ;59(4):429-32
    Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Marmara University, Tophanelioglu Caddesi, Altunizade, Uskudar, Istanbul, Turkey.
    Cholesterol crystal embolism is a multisystem disorder with a high mortality. It is usually seen following vascular surgery and long term anticoagulation therapy, but the diagnosis is often not considered. Skin manifestations are the first sign of cholesterol crystal embolism and recognition of the symptoms is a key element in early diagnosis and prevention of recurrences. Read More

    Systemic cholesterol embolization syndrome associated with myeloperoxidase-anti-neutrophil cytoplasmic antibody.
    Intern Med 2006 15;45(8):557-61. Epub 2006 May 15.
    Department of Medicine, Shiga University of Medical Science, Seta, Otsu.
    A 75-year-old man was transferred to our department because of development of severe renal impairment after coronary artery bypass grafting. Hemodialysis was initiated for postsurgical oliguria and lung congestion. On transfer, he showed systemic purpura rashes and diffuse blue mottlings on his toes with marked eosinophilia and an elevated level of C-reactive protein. Read More

    Cholesterol crystal embolism: diagnosis and treatment.
    Kidney Int 2006 Apr;69(8):1308-12
    Service de Néphrologie, Hôpital Georges Pompidou and Faculté de Médecine René Descartes, Paris, France.
    Cholesterol crystal embolization (CCE) is a dreaded complication of radiology, vascular surgery, and/or anticoagulation in patients with atherosclerosis and ulcerated aortic plaques. It also represents a cause of early graft failure and of poor results of renal artery surgery. Crystals lodge in small caliber renal arteries, where they induce early, transitory thrombosis followed by delayed, definitive obstruction by endarteritis, accompanied by evidence of inflammation and eosinophilia. Read More

    Serum levels of soluble P-selectin are increased and associated with disease activity in patients with Behçet's syndrome.
    Mediators Inflamm 2005 Aug;2005(4):237-41
    Department of Biochemistry, Inönü University Medical Faculty, Turkey.
    Behçet's syndrome (BS) is a relapsing, chronic, inflammatory disease characterized by endothelial dysfunction, atherothromboembogenesis, and leukocytoclastic vasculitis with complex immunologic molecular interactions. Generalized derangements of the lymphocyte and neutrophil populations, activated monocytes, and increased PMNLs motility with upregulated cell surface molecules such as ICAM-1, VCAM-1, and E-selectin, which are found on the endothelial cells, leukocytes, and platelets, have all been demonstrated during the course of BS. Our aim is to investigate the association of serum concentrations of soluble P-selectin in patients with BS, and to evaluate whether disease activity has an effect on their blood levels. Read More

    [Thrombosis of legs arteries: imputability of anti-phosphatidylethanolamine antibodies?].
    Ann Dermatol Venereol 2005 Jun-Jul;132(6-7 Pt 1):555-8
    Service de Médecine Interne, CHU Michallon, Grenoble.
    Background: At the beginning the antiphospholipid antibodies syndrome was associated with systemic lupus erythematosus. But since 1988 it has become a sole entity. Its current definition is based on the criteria established in 1999 by Sapporo and consists of associating the clinical criteria of thrombosis of arteries or peripheral veins and of miscarriage of pregnancy with the biological criteria. Read More

    Cholesterol crystal embolization mimicking vasculitis: success with corticosteroid and cyclophosphamide therapy in two cases.
    Rheumatol Int 2006 Mar 16;26(5):454-60. Epub 2005 Jul 16.
    Division of Rheumatology, Baskent University Faculty of Medicine, 5.sok No:48, Bahcelievler, Ankara, Turkey.
    Cholesterol crystal embolization is a potential complication of atherosclerosis. Approximately one-third of the patients who develop this problem have a history of vascular surgery, angiography or angioplasty hours to weeks before onset. The skin and the kidneys are most frequently involved, but any organ can be affected. Read More

    Cholesterol crystal embolization: skin manifestation, gastrointestinal and central nervous symptom treated with corticosteroid.
    J Dermatol 2005 Apr;32(4):295-8
    Department of Dermatology, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan.
    Cholesterol crystal embolization (CCE) is characterized by tissue ischemia secondary to occlusion of small arteries. It may occur spontaneously but more often follows radiological interventional procedures or vascular surgery. This systemic disease affects multiple organs, including skin, kidney, brain, eye, and gastrointestinal tract. Read More

    Cholesterol crystal embolization: an atherosclerotic disease with frequent and varied cutaneous manifestations.
    J Eur Acad Dermatol Venereol 2003 Sep;17(5):504-11
    Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, Rhode Island, USA.
    In this paper the basic pathogenesis of cholesterol crystal embolization (CCE) is described, its clinical characteristics are presented and diagnosis and therapy are discussed. The main focus will be on the cutaneous manifestations; however, considering that CCE is a systemic illness, findings in other organs will also be highlighted, particularly the commonly involved renal and gastrointestinal systems. Read More

    The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study.
    J Am Coll Cardiol 2003 Jul;42(2):211-6
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
    Background: Cholesterol embolization syndrome is a systemic disease caused by distal showering of cholesterol crystals after angiography, major vessel surgery, or thrombolysis.

    Methods: We prospectively evaluated a total of 1,786 consecutive patients 40 years of age and older, who underwent left-heart catheterization at 11 participating hospitals. The diagnosis of CES was made when patients had peripheral cutaneous involvement (livedo reticularis, blue toe syndrome, and digital gangrene) or renal dysfunction. Read More

    [Immunoallergic interstitial nephritis vs. cholesterol atheroembolism. Differentiating characteristics].
    Nefrologia 2003 ;23(2):125-30
    Servicio de Nefrología, Hospital 12 de Octubre, Avda. de Córdoba, s/n. 28041 Madrid.
    The commonest clinical presentation of both immunoalergic interstitial nephritis (IIN) and atheroembolic renal disease (ATD) is an acute renal failure accompanied by skin lesions and eosinophilia. As a consequence, differential diagnosis between both entities is often very difficult. We have performed a comparative retrospective study of those patients diagnosed as having IIN or ATD in our Hospital in the period 1980-2000. Read More

    Atheroembolization: a harmful complication of therapeutic internal iliac artery occlusion.
    J Vasc Surg 2002 Nov;36(5):1062-5
    Department of Cardiovascular Surgery, University Hospital of Lausanne, Switzerland.
    Coil embolization of the internal iliac artery (IIA) for proper endovascular treatment of aortoiliac aneurysms is a procedure with an acceptable morbidity rate consisting of buttock claudication in 12% to 55% and erectile dysfunction in 1% to 13%. Atheroembolic complications in this context are not yet reported. We present a case with gangrene of the prepuce and focal cutaneous necrosis of the ipsilateral buttock and foot after coil embolization of one IIA. Read More

    [Cholesterol crystal embolism disease, diagnostic criteria].
    Presse Med 2002 Aug;31(27):1271-6
    Service de néphrologiedialyse, CHI André Grégoire, 56, bd de la Boissière 93100 Montreuil.
    FROM AN EPIDEMIOLOGICAL POINT OF VIEW: With the aging of the population and increased indications for angioplasty or anticoagulant therapy, the incidence of cholesterol crystal embolism is going to increase. FROM A CLINICAL POINT OF VIEW: A systemic disease related to multiorgan distal ischemia, cholesterol crystal embolism has multiple facets. Rapidly progressive renal failure, malignant hypertension in the elderly, mesenteric ischemia, acute pulmonary edema, cutaneous ischemia or encephalopathy symptomatology may reveal cholesterol crystal embolism. Read More

    [Renal atheroembolic disease: evaluation of the efficacy of corticosteroid therapy].
    G Ital Nefrol 2002 Jan-Feb;19(1):18-21
    Divisione di Nefrologia, Arcispedale S. Anna, Ferrara, Italy.
    Background: Even though many organs may be involved and clinical manifestations are extremely variable, a sudden worsening of renal function after vascular surgery or invasive angiographic manoeuvres is a clue for the diagnosis of renal cholesterol crystal embolization. In rare cases the disease may also occur spontaneously during anticoagulant or thrombolytic therapy. Renal atheroembolism is becoming increasingly recognized as an important cause of renal failure particularly in elderly men, and is often associated with a bad outcome. Read More

    Cholesterol embolization syndrome: cutaneous histopathological features and the variable onset of symptoms in patients with different risk factors.
    Br J Dermatol 2002 Mar;146(3):511-7
    Department of Dermatology and Pathology, National Naval Medical Center, Bethesda, MD, USA.
    Cholesterol embolization syndrome (CES) may not only be due to direct dislodgement of cholesterol crystals from atherosclerotic plaques on the walls of arteries by surgery, angiogram or trauma, but may occur after anticoagulant and thrombolytic therapy. The latter two therapies both weaken the fibrin clot that stabilizes the atheromas in place; however, these two therapies commonly have different onsets of CES after their institution. We present three patients with different risk factors for CES who all presented with the pathognomonic triad of leg and/or foot pain, livedo reticularis and good peripheral pulses. Read More

    Cholesterol crystal embolization demonstrated on GI biopsy.
    Am J Gastroenterol 2001 Dec;96(12):3301-4
    Service d'Anatomie Pathologique, Hôpital Broussais, Paris, France.
    Objectives: Cholesterol crystal embolism is a severe complication of atherosclerosis responsible for nonspecific cutaneous, renal, and, less often, digestive manifestations that may mimic other systemic diseases.

    Methods: We reviewed retrospectively 10 patients with histologically proven cholesterol crystal emboli diagnosed by endoscopic GI biopsy.

    Results: All patients had prior clinical manifestations of severe atherosclerosis and predisposing factors for cholesterol migration. Read More

    [Skin lesions and renal failure after myocardial infarction].
    Rev Esp Cardiol 2001 Nov;54(11):1339-42
    Servicio de Cardiología, Hospital General de Albacete, Albaceta.
    We describe the clinical case of a patient with acute myocardial infarction treated with t-PA fibrinolysis, who developed renal failure and cutaneous lesions of the livedo reticularis type, probably caused by embolization of cholesterol crystals. The main characteristics of this rare clinical entity are reviewed. Read More

    [Cholesterol crystals embolization. A case report].
    An Med Interna 2001 Apr;18(4):201-4
    Servicio de Medicina Interna, Hospital La Fe, Valencia.
    Cholesterol Crystals Embolization is not a very frequent entity that happens in people with atheromatous disease of spontaneous for or after the realization of vascular manipulation (angiographic, angioplasty procedures, cardiovascular surgery) or more rarely with the treatment with oral anticoagulants and after thrombolytic therapy. The clinical presentation is according to the arterial affected territory and so from diagnosed cases in autopsy reports to florid clinic forms exist. The more frequent are the cutaneous manifestations with apparition of livedo reticularis and purple toes that could go accompanied of necrosis of lower limbs, consecutive from the renal manifestations and the gastrointestinal tract one. Read More

    Potential therapeutic effect of simvastatin on progressive renal failure and nephrotic-range proteinuria caused by renal cholesterol embolism.
    Am J Med Sci 2001 Jul;322(1):50-2
    Hemodialysis Unit, Hamamatsu University School of Medicine, Japan.
    We report our experience with a 62-year-old Japanese man with cholesterol crystal embolism after angiographic procedures performed because of intermittent claudication. In addition to progressive renal failure and nephrotic-range proteinuria, cutaneous ischemia, consisting of livedo reticularis in the lower limbs and digital necrosis at the tip of the right toe, and fundoscopic findings showing several white spots in the branches of retinal artery were also observed. Progressive renal failure and nephrotic-range proteinuria were halted just after treatment with simvastatin. Read More

    Livedo reticularis: an underutilized diagnostic clue in cholesterol embolization syndrome.
    Am J Med Sci 2001 May;321(5):348-51
    Department of Nephrology, University of Tennessee, Memphis, USA.
    Background: Cholesterol embolization syndrome (CES) is an increasingly recognized cause of acute renal insufficiency, which must be differentiated from other forms of systemic vasculitis by histologic examination of biopsies from involved organs. This report describes the optimal methods for detection and biopsy of areas of skin involved with livedo reticularis to confirm the diagnosis of CES.

    Methods: This report describes 8 patients with unexplained acute renal insufficiency in whom the diagnosis of CES was suspected based on their clinical history. Read More

    [Cholesterol embolism disease: study of 16 cases].
    Rev Clin Esp 2000 Dec;200(12):659-63
    Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona.
    Background: The cholesterol embolism syndrome is a multisystemic disease resulting from cholesterol crystal embolization to many organs including skin, kidney and CNS. Vascular procedures and anticoagulation have been identified as triggering factors.

    Patients And Methods: Sixteen patients were prospectively reviewed diagnosed of cholesterol embolism syndrome from 1991 to 1998. Read More

    [Ischemic cholecystitis from cholesterol crystal embolism].
    Gastroenterol Clin Biol 1999 May;23(5):577-80
    Service d'Anatomie Pathologique, Hôpital Broussais, Paris.
    Cholesterol crystal embolism is a serious complication of atherosclerosis resulting in renal, cutaneous and rarely digestive manifestations. We report two cases of systemic cholesterol crystal embolization with gallbladder involvement in two patients with gallstones, severe atherosclerosis with an abdominal aortic aneurysm as well as predisposing factors for cholesterol crystal migration. These two cases show that, like vasculitis, cholesterol crystal embolization may result in ischemic cholecystitis, and that diagnosis of cholesterol crystal embolization on routine cholecystectomy suggests severe systemic involvement and a poor prognosis. Read More

    [Cholesterol crystal embolisms in adenomatous polyposis coli].
    Ann Pathol 1999 Apr;19(2):135-8
    Service d'Anatomie Pathologique, Hôpital Broussais, Paris.
    Cholesterol crystal embolism is a serious complication of atherosclerosis responsible for renal, cutaneous and less often digestive manifestations. We report a case of cholesterol crystal embolization in an adenomatous colonic polyp with foci of adenocarcinoma in a patient with an abdominal aortic aneurysm taking anticoagulant therapy. This case shows that cholesterol crystal embolization may be diagnosed by microscopic examination of a colonic polyp. Read More

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