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Cholesterol embolism 

Cholesterol embolism

Chapter:
Cholesterol embolism
Author(s):

Christopher Dudley

DOI:
10.1093/med/9780199204854.003.161403_update_002

Update:

Chapter reviewed in January 2014 – minor alterations made, including two new references.

Updated on 27 Nov 2014. The previous version of this content can be found here.
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date: 19 August 2017

Cholesterol embolism occurring after vascular surgery or intra-arterial angiographic procedures is not uncommon, but is often unrecognized. The clinical features mimic a number of conditions, including contrast nephropathy and systemic vasculitis, and—if misdiagnosed—can result in the inappropriate use of powerful immunosuppressive drugs. A high index of suspicion is required when an elderly patient with widespread vascular disease develops a nonspecific systemic illness with progressive renal impairment, particularly after vascular surgery or arteriography. Biopsy of affected tissue, especially skin or kidney, is diagnostic—showing biconvex, needle-shaped cholesterol clefts within the lumen of arteries or arterioles. Treatment is supportive and the prognosis is often poor....

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