Proceedings: Cholesterol emboli causing gangrene of the extremities

Calhoun, Pauletta

doi:10.1001/archderm.111.10.1373

Cited by 11 publications

(4 citation statements)

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“…The course of renal failure associ ated with atheroembolic renal disease is con trasted with that associated with contrast me dia (stippled background). The course of each patient is indicated by respective roman nu meral (the data of contrast media-associated acute renal failure was adapted from [20]). missed unless WBC counts are closely monitored.…”

Section: Discussionmentioning

confidence: 99%

“…The former has been referred to as 'a masquerader of polyar teritis' [7], Some features help in differentiating the two diseases: eosinophilia is rare in classic PAN [18,19]; it is unusual to have bland urine sediment on repeated urina lysis if moderate to severe renal failure is due to polyar teritis, while this is common in atheroembolic renal dis ease [2], Diagnostic confirmation of atheroembolism may be obtained by biopsy of the kidney [ 1 ], muscle [ 10], bone marrow [13] or skin [20].…”

Section: Discussionmentioning

confidence: 99%

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Eosinophilia in the Diagnosis of Atheroembolic Renal Disease

et al. 1987

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We report 6 patients with eosinophilia and atheroembolic renal disease. Histologic examination of biopsy of kidney or skin revealed extensive atheroemboli in the vasculature. However, no evidence of vascular or tubulointerstitial inflammation was observed. Eosinophil count ranged from 540 to 2,000 cells/mm³. Upon review of the literature, 80% (29 out of 36) of patients with adequately reported total and differential leukocyte counts had eosinophilia in association with atheroembolic disease. In contrast, review of the clinical records of 40 consecutive patients with acute renal failure seen during an 18-month period uncovered only 1 case of eosinohilia (2.5%). This latter patient was established as having acute interstitial nephritis. Thus eosinophilia appears to be a helpful diagnostic clue to the presence of atheroembolic renal disease

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Eosinophilia in the Diagnosis of Atheroembolic Renal Disease

et al. 1987

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“…Fifteen of 129 patients (12%) had neu rological complications [9][10][11][12]21,36,56]. Retinal emboli were seen in only 10% of cases [9,12,16,22,44,55,56,61]. Gastrointestinal involvement causing hemorrhage, infarction or perforation was seen in 12% of patients [43-45, 54,63].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Early cases were mainly diagnosed at postmortem. In the 129 cases reviewed, 31% were diagnosed by a kidney biopsy [1-3, 7, 8, 12, 15, 18, 21, 23, 33, 35, 40, 42, 45, 46,49, 55-57, 66], 21% by a muscle biopsy [12,28,36,38,43,44,61] and 17% by a skin biopsy [12,22,35,36,38,43,52], Nine percent of cases were diagnosed based on the clinical presentation, and 22% were diagnosed by post mortem.…”

Section: Clinical Presentationmentioning

confidence: 99%

Renal Cholesterol Embolic Disease

Lye

Cheah²,

Sinniah³

1993

Am J Nephrol

111

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Renal cholesterol embolization is a rare disease occurring usually in elderly men who had undergone an angiographic procedure or vascular surgery. We report a man who developed systemic cholesterol embolic disease and acute renal failure after coronary angiography. A review of the English literature for renal cholesterol embolic disease revealed a high incidence of eosinophila (71 %). Livedo reticularis and digital infarcts occurred in more than 30% of patients. Forty percent of patients required dialysis for acute renal failure of whom only one fifth recovered sufficient renal function to stop dialysis. The overall mortality was high at 64%. Skin, muscle and kidney biopsies remain the main tools for diagnosis.

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The Cutaneous Manifestations of Cholesterol Crystal Embolization

Falanga¹

1986

Arch Dermatol

166

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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%). Cholesterol crystal embolization was most common in older men and was frequently associated with anticoagulant therapy (36%) or vascular procedures (31%). Because of its protean systemic manifestations, CCE was often mistaken for vasculitis (16%) and periarteritis nodosa (12%). Mortality was very high (72%). Histologic confirmation of cutaneous CCE was possible in 92% of cases where a skin biopsy specimen was obtained. We conclude that the diagnosis of cutaneous CCE should be suggested and easily confirmed histologically in the appropriate clinical setting.

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Proceedings: Cholesterol emboli causing gangrene of the extremities

Cited by 11 publications

References 0 publications

Eosinophilia in the Diagnosis of Atheroembolic Renal Disease

Eosinophilia in the Diagnosis of Atheroembolic Renal Disease

Renal Cholesterol Embolic Disease

The Cutaneous Manifestations of Cholesterol Crystal Embolization

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