Authors: A E Yücel H KartKöseoglu B Demirhan F N Özdemir
Publish Date: 2005/07/16
Volume: 26, Issue: 5, Pages: 454-460
Abstract
Cholesterol crystal embolization is a potential complication of atherosclerosis Approximately onethird 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 Livedo reticularis of the lower extremities and acrocyanosis known as “blue toe syndrome” are the most common cutaneous manifestations Histological examination is the only way to definitively diagnose cholesterol crystal embolization Recently it has been proposed that cholesterol embolization is associated with vasculitis and some authors have labeled this condition a “vasculitis lookalike” There is still no specific treatment for this problem even in cases that progress to renal failure However a few case reports in the literature have noted successful treatment with corticosteroids and cyclophosphamide in patients with deteriorating renal function In this article we describe two cases of severe cholesterol crystal embolization accompanied by renal dysfunction and blue toe syndrome Both patients benefited from corticosteroid and cyclophosphamide therapy
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