Atheroembolic renal disease with rapid progression and fatal outcome
Atheroembolic renal disease is caused by foreign-body reaction to cholesterol crystals flushed from the atherosclerotic plaques into the small-vessel system of the kidneys. It is an underdiagnosed entity, mostly related to vascular procedures and/or anticoagulation, and prognosis is considered to be...
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| Veröffentlicht in: | Clinical and experimental nephrology 2011-02, Vol.15 (1), p.159-163 |
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| creator | Faria, Bernardo Vidinha, Joana Pêgo, Cátia Garrido, Jesus Lemos, Sérgio Lima, Carla Sorbo, Giovanni Gomes, Edgar Lorga Carvalho, Teresa Loureiro, Paulo Sousa, Tânia |
| description | Atheroembolic renal disease is caused by foreign-body reaction to cholesterol crystals flushed from the atherosclerotic plaques into the small-vessel system of the kidneys. It is an underdiagnosed entity, mostly related to vascular procedures and/or anticoagulation, and prognosis is considered to be poor. Besides the benefit of aggressive medical prevention of further embolic events, use of steroid therapy has been associated with greater survival. Here we report a case of a patient with a multisystemic presentation of the disease days after performance of percutaneous coronary intervention and anticoagulation initiation due to an episode of myocardial infarction. Renal, cutaneous, ophthalmic, neurological, and possibly muscular and mesenteric involvement was diagnosed. Although medical treatment with corticosteroids and avoidance of further anticoagulation was applied, the patient rapidly progressed to end-stage renal disease requiring hemodialysis and died 6 months after diagnosis. This is a case of catastrophic progression of the disease resistant to therapeutic measures. Focus on diagnosis and more efficient preventive and therapeutic protocols are therefore needed. |
| doi_str_mv | 10.1007/s10157-010-0363-3 |
| format | Article |
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It is an underdiagnosed entity, mostly related to vascular procedures and/or anticoagulation, and prognosis is considered to be poor. Besides the benefit of aggressive medical prevention of further embolic events, use of steroid therapy has been associated with greater survival. Here we report a case of a patient with a multisystemic presentation of the disease days after performance of percutaneous coronary intervention and anticoagulation initiation due to an episode of myocardial infarction. Renal, cutaneous, ophthalmic, neurological, and possibly muscular and mesenteric involvement was diagnosed. Although medical treatment with corticosteroids and avoidance of further anticoagulation was applied, the patient rapidly progressed to end-stage renal disease requiring hemodialysis and died 6 months after diagnosis. This is a case of catastrophic progression of the disease resistant to therapeutic measures. 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Vidinha, Joana ; Pêgo, Cátia ; Garrido, Jesus ; Lemos, Sérgio ; Lima, Carla ; Sorbo, Giovanni ; Gomes, Edgar Lorga ; Carvalho, Teresa ; Loureiro, Paulo ; Sousa, Tânia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-704b75aa3ec2c168823961db7c6247fb29c8ec97c13c63767db040d17a47dda63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Case Report</topic><topic>Embolism, Cholesterol - complications</topic><topic>Embolism, Cholesterol - immunology</topic><topic>Embolism, Cholesterol - mortality</topic><topic>Embolism, Cholesterol - pathology</topic><topic>Fatal Outcome</topic><topic>Foreign-Body Reaction - complications</topic><topic>Humans</topic><topic>Kidney Diseases - etiology</topic><topic>Kidney Diseases - mortality</topic><topic>Kidney Diseases - pathology</topic><topic>Kidney Diseases - physiopathology</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - physiopathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Renal Dialysis</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Faria, Bernardo</creatorcontrib><creatorcontrib>Vidinha, Joana</creatorcontrib><creatorcontrib>Pêgo, Cátia</creatorcontrib><creatorcontrib>Garrido, Jesus</creatorcontrib><creatorcontrib>Lemos, Sérgio</creatorcontrib><creatorcontrib>Lima, Carla</creatorcontrib><creatorcontrib>Sorbo, Giovanni</creatorcontrib><creatorcontrib>Gomes, Edgar Lorga</creatorcontrib><creatorcontrib>Carvalho, Teresa</creatorcontrib><creatorcontrib>Loureiro, Paulo</creatorcontrib><creatorcontrib>Sousa, Tânia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Faria, Bernardo</au><au>Vidinha, Joana</au><au>Pêgo, Cátia</au><au>Garrido, Jesus</au><au>Lemos, Sérgio</au><au>Lima, Carla</au><au>Sorbo, Giovanni</au><au>Gomes, Edgar Lorga</au><au>Carvalho, Teresa</au><au>Loureiro, Paulo</au><au>Sousa, Tânia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atheroembolic renal disease with rapid progression and fatal outcome</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>15</volume><issue>1</issue><spage>159</spage><epage>163</epage><pages>159-163</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><coden>CENPFV</coden><abstract>Atheroembolic renal disease is caused by foreign-body reaction to cholesterol crystals flushed from the atherosclerotic plaques into the small-vessel system of the kidneys. It is an underdiagnosed entity, mostly related to vascular procedures and/or anticoagulation, and prognosis is considered to be poor. Besides the benefit of aggressive medical prevention of further embolic events, use of steroid therapy has been associated with greater survival. Here we report a case of a patient with a multisystemic presentation of the disease days after performance of percutaneous coronary intervention and anticoagulation initiation due to an episode of myocardial infarction. Renal, cutaneous, ophthalmic, neurological, and possibly muscular and mesenteric involvement was diagnosed. Although medical treatment with corticosteroids and avoidance of further anticoagulation was applied, the patient rapidly progressed to end-stage renal disease requiring hemodialysis and died 6 months after diagnosis. This is a case of catastrophic progression of the disease resistant to therapeutic measures. Focus on diagnosis and more efficient preventive and therapeutic protocols are therefore needed.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>21069411</pmid><doi>10.1007/s10157-010-0363-3</doi><tpages>5</tpages></addata></record> |
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| ispartof | Clinical and experimental nephrology, 2011-02, Vol.15 (1), p.159-163 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Case Report Embolism, Cholesterol - complications Embolism, Cholesterol - immunology Embolism, Cholesterol - mortality Embolism, Cholesterol - pathology Fatal Outcome Foreign-Body Reaction - complications Humans Kidney Diseases - etiology Kidney Diseases - mortality Kidney Diseases - pathology Kidney Diseases - physiopathology Kidney Failure, Chronic - mortality Kidney Failure, Chronic - physiopathology Male Medicine Medicine & Public Health Nephrology Renal Dialysis Urology |
| title | Atheroembolic renal disease with rapid progression and fatal outcome |
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