cholesterol embolisation syndromeJoe Segen2016-11-08T06:00:02+00:00
cholesterol embolisation syndrome
A condition affecting ± 4/10,000, more often in men ≥ age 60, in which showers of cholesterol and debris from atherosclerotic plaques embolise to renal arterioles, blocking blood flow, resulting in renal infarction and possibly renal failure.
Clinical findings Fever, weight loss, malaise, myalgia, acute respiratory distress due to circulating inflammatory mediators, hypercatabolism.
Lab Eosinophilia, elevated BUN and creatinine, urinalysis shows hyaline casts and eosinophils; renal biopsy shows crystals in tissue.
Risk factors Males, coronary heart disease, hypertension, smoking, obesity, increased C-reactive protein, hyperlipidaemia; mitral valve annular calcification.
Pathogenesis Cholesterol embolism requires an atherotic plaque in a proximal large-calibre artery; rupture of the plaque; embolisation of plaque debris; lodging of the emboli in small-to-medium arteries resulting in obstruction; end-organ damage due to mechanical plugging and inflammation; foreign-body inflammatory response to cholesterol emboli.
Synonyms Atheroembolic renal disease, atheroembolism, cholesterol crystal embolisation, cholesterol embolism syndrome