Internal medicine (Tokyo, Japan) · 2019
A Catastrophic Case of Idiopathic Cholesterol Crystal Embolism with Multiple Lethal Complications: A Labyrinth Underneath the Diagnosis of Skin Ulcers in Chronic Kidney Disease Patients.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Kumakura Satoshi, Nakamichi Takashi, Suzuki Nonoka, Yamakage Shu, Ishikawa Ayako, Fujikura Emi, Sato Satoko, Aoki Takeshi, Musha Hiroaki, Kikuchi Katsuko, Nagasawa Tasuku, Sato Hiroshi, Ito Sadayoshi, Miyazaki Mariko
Аннотация
A 66-year-old man was admitted to our hospital because of multiple refractory skin ulcers. Based on his severe systemic arterial calcification and severe calcium-phosphate imbalance due to severe kidney dysfunction, we initially considered calciphylaxis. However, a skin biopsy provided a diagnosis of cholesterol crystal embolization. Although we initiated hemodialysis, steroid treatment, and low-density lipoprotein-cholesterol apheresis, he died of multiple intestinal perforation. An autopsy showed cholesterol crystals occluding multiple organ arterioles. This case suggests that skin ulcers in patients with chronic kidney disease may be an important diagnostic hallmark and may be associated with several serious diseases.