Atheroembolic renal disease with rapid progression and fatal outcome
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Bernardo Faria Joana Vidinha Ca´tia Peˆgo Jesus Garrido Se´rgio Lemos Carla Lima Giovanni Sorbo Edgar Lorga Gomes Teresa Carvalho Pa
- چاپ و سال / کشور: 2011
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.
Clin Exp Nephrol (2011) 15:159–163, Received: 17 July 2010 / Accepted: 29 September 2010 / Published online: 11 November 2010 Japanese Society of Nephrology 2010
