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

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Internal Medicine Pub Date : 2024-12-15 Epub Date: 2024-05-09 DOI:10.2169/internalmedicine.3469-24
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, Yasunori Iwata
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Abstract

A 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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胆固醇晶体栓塞:尸检证实接受选择性腹部血管造影术后出现胃肠道病变、胰腺炎和终末期肾病。
一名患有动脉粥样硬化症的 78 岁老人通过腹腔动脉和肠系膜上动脉(SMA)经腿血管造影术确诊为肝细胞癌。手术后,血清检查发现,除了活动性胃溃疡和胰腺炎外,患者还出现了进行性肾功能衰竭,并伴有嗜酸性粒细胞增多,导致终末期肾病。双侧脚趾发绀,皮肤活检显示为胆固醇结晶栓塞(CCE)。尸检显示,CCE累及多个器官的动脉血管,其分布在解剖学上与腹腔动脉和SMA的血管区域一致。因此,血管造影后发现血管区域有多种组织损伤的患者应考虑到 CCE。
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来源期刊
Internal Medicine
Internal Medicine 医学-医学:内科
CiteScore
1.90
自引率
8.30%
发文量
0
审稿时长
2.2 months
期刊介绍: Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.
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