30 results match your criteria Cutaneous Manifestations of Cholesterol Embolism

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A case of cholesterol embolization syndrome mimicking rapidly progressive renal failure causing end-stage kidney disease.

Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1489-1494

Department of Nephrology, Command Hospital Air Force, Bengaluru, Karnataka, India.

Cholesterol embolization syndrome is an uncommon complication of coronary angioplasty. Its clinical manifestations are nonspecific and may be ascribed to other causes mimicking vasculitis syndrome. In an appropriate clinical setting, the diagnosis can be confirmed by tissue biopsy. Read More

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Mimics of vasculitis.

Rheumatology (Oxford) 2021 01;60(1):34-47

Division of Rheumatology, University of California, Los Angeles, Los Angeles, CA, USA.

While prompt diagnosis of vasculitis is important, recognition of vasculitis mimics is equally essential. As in the case of vasculitis, an approach to mimics based on the anatomic size of vessels can be useful. Infections can mimic vasculitis of any vessel size, including the formation of aneurysms and induction of ANCAs. Read More

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January 2021

Cholesterol Embolization Syndrome After Carotid Artery Stenting Associated with Delayed Cerebral Hyperperfusion Intracerebral Hemorrhage.

World Neurosurg 2020 10 15;142:274-282. Epub 2020 Jul 15.

Neuroendovascular Therapy Center, Aichi Medical University, Aichi, Japan; Department of Neurosurgery, Aichi Medical University, Aichi, Japan.

Background: The cholesterol embolization syndrome (CES) results from the distal embolization of cholesterol crystals from atheromatous plaques in large vessels such as the aorta and results in multiorgan damage.

Case Description: We present the case of a patient with definite CES with skin manifestations (e.g. Read More

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October 2020

[Benign Presentation of a Potentially Fatal Disease].

Rev Port Cir Cardiotorac Vasc 2018 Jan-Jun;25(1-2):77-82

Medicina Geral e Familiar, Unidade de Saúde Familiar São Martinho, Penafiel, Portugal.

Atheroembolism is a rare multisystemic disorder that is characterized by release of cholesterol crystals and particles from atheromatous plaques, which can occlude distal vessels and induce an inflammatory response. Most affected individuals are males, older than 60 years of age, with advanced atherosclerotic disease. The abdominal aorta is the most common origin of cholesterol emboli, being the peripheral arteries a rarer source. Read More

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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

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December 2016

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

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October 2008

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

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October 2008

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

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November 2006

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

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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

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September 2006

[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

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September 2005

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

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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

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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

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September 2003

[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

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[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

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November 2002

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

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December 2001

[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

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[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

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December 2000

[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

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[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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Use of a prostacyclin analogue in cholesterol crystal embolism.

Diabet Med 1998 Mar;15(3):262-3

Department of Metabolic Diseases, CHU Lapeyronie, Montpellier, France.

The prognosis of cholesterol embolism is often poor, and no treatment is presently available. We report the use of a stable prostacyclin analogue in treating cholesterol embolism in a diabetic patient with arteriopathy. As a sole therapy, it improved cutaneous manifestations and pain, in parallel with an increased transcutaneous oxymetry. Read More

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[Cholesterol embolism: a diagnostic puzzle and a therapeutic dilemma].

B Balestra

Schweiz Rundsch Med Prax 1994 May;83(19):566-9

Medizinische Abteilung, Ospedale della Beata Vergine, Mendrisio.

A well documented and histologically proven case of cholesterol embolism is discussed, and the recent literature is reviewed. This disorder is usually underdiagnosed and commonly detected only at autopsy. Elderly people with atherosclerotic vascular disease are predominantly affected. Read More

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An institutional experience with arterial atheroembolism.

Ann Vasc Surg 1994 May;8(3):258-65

Department of Surgery, Washington University School of Medicine, St. Louis, Mo.

Seemingly minor blue-toe lesions resulting from atheroemboli are associated with unstable atherosclerotic plaques, which are at risk for causing recurrent emboli, tissue loss, and potentially death. At Washington University Medical Center, 62 patients (31 males and 31 females), ranging in age from 38 to 89 years (mean 62.8 +/- 11. Read More

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Pleural effusion in patients with systemic cholesterol embolization.

Chest 1993 Mar;103(3):792-5

Department of Medicine, Fitzsimons Army Medical Center, Aurora, Col.

We evaluated two patients with systemic cholesterol embolization (SCE) associated with the development of pleural effusions. These two patients had evidence of atherosclerosis and presented with livedo reticularis, renal insufficiency, and gangrenous cutaneous changes as manifestations of their SCE. In both cases, closed pleural biopsies demonstrated acute inflammation of the parietal pleura. Read More

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Management of multiple cholesterol embolization syndrome--a case report.

Angiology 1990 Mar;41(3):248-52

Department of Cardiology, Otsu Red Cross Hospital, Shiga, Japan.

A sixty-two-year-old man who underwent coronary angiography and received acute thrombolytic and anticoagulant therapy for acute myocardial infarction developed multisystemic injury, including renal insufficiency and cutaneous manifestations. Fundoscopic examination and skin biopsy specimen led to the diagnosis of multiple cholesterol embolization syndrome (MCES). Discontinuation of anticoagulants and administration of hemostatic (carbazochrome, tranexamic acid, reptilase, and vitamin K) and antihyperlipidemic (cholestyramine and probucol) drugs resulted in temporary improvement of cutaneous and renal disorders and extended survival for about one year. Read More

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Cholesterol crystal embolization: a review of 221 cases in the English literature.

Angiology 1987 Oct;38(10):769-84

Department of Internal Medicine, University of Pittsburgh, PA.

Cholesterol crystal embolization (CCE) frequently presents with nonspecific manifestations that mimic other systemic diseases. The authors reviewed 221 cases of histologically proven CCE in the English literature to define the clinical, laboratory, and pathologic characteristics of this disorder. CCE affected predominantly elderly males (mean age sixty-six) with a frequent history of hypertension (61%), atherosclerotic cardiovascular disease (44%), renal failure (34%), and aortic aneurysms (25%) at presentation. Read More

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October 1987

The cutaneous manifestations of cholesterol crystal embolization.

Arch Dermatol 1986 Oct;122(10):1194-8

In an effort to provide a greater understanding of the cutaneous features of cholesterol crystal embolization (CCE), we reviewed the clinical features of all histologically proved cases reported in the English-language literature, exclusive of cases in which there was only central nervous system or cardiac involvement. We found that the skin is involved in 35% of patients with CCE. Livedo reticularis is the most common skin manifestation (49%), followed by gangrene (35%), cyanosis (28%), ulceration (17%), nodules (10%), and purpura (9%). Read More

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October 1986

Cholesterol embolism as a complication of left heart catheterisation. Report of seven cases.

Br Heart J 1984 Sep;52(3):339-42

Cholesterol embolism after left heart catheterisation by the femoral approach was diagnosed in seven men (mean age 59.6 years) out of a total of 4587 catheterisations. Diabetes was present in four patients, systemic hypertension in three, and signs of extensive atherosclerosis in six; five patients were taking anticoagulant drugs. Read More

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September 1984
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