A fatal case of systemic fat embolism resulting from gluteal injections of vitamin e for cosmetic enhancement

Mendoza-Morales, Roberto Cuauhtemoc; Camberos-Nava, E.V.; Luna-Rosas, A.; Garcés‐Ramírez, Linda; Cruz, Fidel de la; García-Dolores, Fernando

doi:10.1016/j.forsciint.2015.11.012

Cited by 13 publications

(11 citation statements)

References 12 publications

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“…We have described a rare case of non‐traumatic FES. Previously reported cases of non‐traumatic FES are summarized in Table . Although there have been several reports of non‐ traumatic FES associated with fatty liver, this is the first report of non‐traumatic FES associated with hepatocellular carcinoma.…”

Section: Discussionmentioning

confidence: 98%

“…Nevertheless, this is the first report of lipid analysis being employed in a case of non‐traumatic FES using human autopsy specimens that contained fat emboli (Table ). Although Mendoza et al employed gas chromatography coupled with mass spectrometry to examine oily material between muscle fibers in buttock area since the patient got gluteal injection of vitamin E before death, the authors did not analyze the organ that contained fat embolism. Moreover, hitherto, lipid analysis of human FES using organ samples which contain fat embolism was conducted only by using bronchoalveolar lavage .…”

Section: Discussionmentioning

confidence: 99%

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An autopsy case of non‐traumatic fat embolism syndrome

Sakashita

Sakamoto

et al. 2017

Pathology International

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Fat embolism syndrome (FES) occurs after long bone fractures and the symptoms appear 24-72 h after the initial trauma. Fat emboli can affect both the pulmonary and systemic circulation. Apart from the most common type of FES that originates from bone fracture, non-traumatic FES has been also reported. We have experienced an autopsy case of non-traumatic FES. An 81-year-old man with hepatocellular carcinoma associated with alcoholic liver cirrhosis suddenly lost consciousness before transcatheter arterial chemoembolization treatment for his disease and died 5 h after the episode. At autopsy, numerous fat droplets were detected in the alveolar capillaries of the lung and glomerular capillaries of the kidney. Lipid analysis of lung autopsy specimens by thin-layer chromatography showed that the emboli were composed mainly of tristearin. Free fatty acids (FFA) has been considered to be the main component of fat emboli and can be a cause of acute respiratory distress syndrome (ARDS). However, in the present case, the lung specimen contained tristearin and ARDS did not occur. This is the first report of non-traumatic FES in which lipid analysis of human autopsy specimens has been conducted.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

An autopsy case of non‐traumatic fat embolism syndrome

Sakashita

Sakamoto

et al. 2017

Pathology International

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“…[ 14 ] Fat droplets were also found in blood, sputum, alveolar lavage fluid, and urine of healthy people. [ 8 , 15 ] Because under normal circumstances, the human blood circulation also contains triglycerides, cholesterol and chylous particles, and other components. At present, there is no simple and convenient method with high specificity and sensitivity to diagnose FE.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors reported mortality rates up to 60%. [ 8 ] At present, clinical diagnosis of FE mainly depends on pathologic diagnosis. There is no gold standard for diagnosis of FES.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of increased peripheral venous blood adipocyte-specific protein FABP4 after joint replacement

Wang¹,

Na²,

Zhang³

et al. 2020

Medicine

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“…It is most frequently observed following severe trauma, particularly long bone fractures and contusions in soft tissue rich in adipose tissue. Nontraumatic pulmonary fat embolism associated with minor soft tissue contusion [2,3], surgery, cancer chemotherapy, hematologic disorders and so on has also been reported [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Intrinsic or extrinsic stimuli evokes a biological response, known as stress [19]; stress can be induced by trauma, blood loss, hypoxia, pain, heat and cold, fear, infection, surgery, and anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Rare, Fatal Pulmonary Fat Embolism after Acupuncture Therapy: A Case Report and Literature Review

Tan

Chen

et al. 2020

Preprint

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Background: In the clinic, death from nontraumatic pulmonary fat embolism associated with minor soft tissue contusion, surgery, cancer chemotherapy, hematologic disorders and so on has been reported. Patients often present with atypical manifestations and rapid deterioration, making diagnosis and treatment difficult. However, there are no reported cases of death from pulmonary fat embolism after acupuncture therapy. This case aims to emphasize that awareness of nontraumatic pulmonary fat embolism as a complication of acupuncture therapy needs to be improved. In addition, it suggests that in such cases, autopsy should be used to identify the source of fat emboli. Case presentation: The patient, a 72-year-old woman, experienced symptoms of dizziness and fatigue after silver-needle acupuncture therapy. She experienced a significant drop in blood pressure and died 2 hours later despite treatment and resuscitation. A systematic autopsy and histopathology examination (H&E and Sudan Ⅲ staining) were performed. More than 30 pinholes were observed on the surface of the lower back. Focal hemorrhages were seen surrounding the pinholes in the subcutaneous fatty tissue. Microscopically, numerous fat emboli were observed in the interstitial pulmonary artery and a large number of alveolar wall capillaries, in addition to the vessels of the heart, liver, spleen and thyroid gland. The lungs showed congestion and edema. However, the cause of death was identified as pulmonary fat embolism. Conclusion: This article suggests that high vigilance for risk factors and the complication of pulmonary fat embolism following silver-needle acupuncture therapy should be exercised. In postmortem examinations, examining the peripheral arterial system and the venous system draining from noninjured sites for the formation of fat emboli is helpful to differentiate posttraumatic and nontraumatic pulmonary fat embolism.

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A fatal case of systemic fat embolism resulting from gluteal injections of vitamin e for cosmetic enhancement

Cited by 13 publications

References 12 publications

An autopsy case of non‐traumatic fat embolism syndrome

An autopsy case of non‐traumatic fat embolism syndrome

Clinical significance of increased peripheral venous blood adipocyte-specific protein FABP4 after joint replacement

Rare, Fatal Pulmonary Fat Embolism after Acupuncture Therapy: A Case Report and Literature Review

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