Acute renal failure due to cholesterol crystal embolism treated with LDL apheresis followed by corticosteroid and candesartan.
Clin Exp Nephrol
; 7(1): 67-71, 2003 Mar.
Article
en En
| MEDLINE
| ID: mdl-14586747
ABSTRACT
Cholesterol crystal embolism (CCE) is caused by the shedding of cholesterol crystals into the bloodstream, and it has been recently recognized as a serious complication after vascular procedures. Our case of CCE, which was diagnosed by skin and renal biopsies, occurred in a patient with hypertension and diabetes mellitus, 3 months after coronary angiography, with the development of renal failure and blue toes. After low-density lipoprotein apheresis (LDL-A), the skin lesions, including livedo reticularis and pain from the acrocyanotic toes, dramatically improved, with partial recovery of renal function. Following the administration of low-dose corticosteroid and candesartan--an angiotensin II type 1 receptor antagonist (ARB)--the eosinophilia disappeared and renal function improved gradually with a decrease in urinary protein excretion. Therefore, a combination therapy of LDL-A, low-dose corticosteroid, and an ARB is a possible treatment for CCE, although the possibility of spontaneous recovery of renal function cannot be eliminated for this patient.
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Bases de datos:
MEDLINE
Asunto principal:
Tetrazoles
/
Bencimidazoles
/
Corticoesteroides
/
Embolia por Colesterol
/
Bloqueadores del Receptor Tipo 1 de Angiotensina II
/
Lesión Renal Aguda
/
Lipoproteínas LDL
Tipo de estudio:
Diagnostic_studies
Límite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Clin Exp Nephrol
Asunto de la revista:
NEFROLOGIA
Año:
2003
Tipo del documento:
Article
País de afiliación:
Japón