Embolias de colesterol: Caso clínico

We report a 72 year-old male, that after a coronary angiogram presented pain, reduced distal skin temperature of both limbs, cyanosis of toes with preserved peripheral pulses and a rapidly progressive renal failure. Afterwards, the patient suffered a sudden bilateral amblyopia and hematochezia. Chol...

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Autores principales: Dufrechou,Carlos, Cedrés,Santiago, Bruno,Lorena, Quintana,Marcela, Costa,Virginia, Bagattini,Juan Carlos
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2006
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006001100012
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Sumario:We report a 72 year-old male, that after a coronary angiogram presented pain, reduced distal skin temperature of both limbs, cyanosis of toes with preserved peripheral pulses and a rapidly progressive renal failure. Afterwards, the patient suffered a sudden bilateral amblyopia and hematochezia. Cholesterol embolism was confirmed with a skin biopsy and fundoscopy. A colonoscopy showed a possible ischemic colitis. After six months of follow up, the patient lost the distal phalanges of three toes, and renal failure stabilized, with a serum creatinine of 2.5 mg/dl. The diagnosis of cholesterol embolism is often missed, but it has a one year mortality of 80% and the presence of renal failure is the main prognostic indicator. Other prognostic indicators are the presence of high blood pressure, previous renal failure and peripheral artery disease