Systemic Cholesterol Embolization Syndrome Associated with Myeloperoxidase-anti-neutrophil Cytoplasmic Antibody
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概要
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A 75-year-old man was transferred to our department because of development of severe renal impairment after coronary artery bypass grafting. Hemodialysis was initiated for postsurgical oliguria and lung congestion. On transfer, he showed systemic purpura rashes and diffuse blue mottlings on his toes with marked eosinophilia and an elevated level of C-reactive protein. Cutaneous biopsy revealed cholesterol crystal embolism and leukocytoclastic vasculitis in dermal arterioles. Myeloperoxidase-anti-neutrophil cytoplasmic antibody titer was increased. Upon oral corticosteroid therapy following intravenous pulse steroid therapy, the purpura dramatically diminished, renal function improved, and hemodialysis was discontinued. Active treatment with corticosteroids may be effective for cholesterol embolization syndrome, particularly when clinical and laboratory manifestations mimic systemic vasculitis.
- 社団法人 日本内科学会の論文
著者
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SUGIMOTO Toshiro
Department of Medicine, Shiga University of Medical Science
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YOKOMAKU Yukiyo
Department of Medicine, Shiga University of Medical Science
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ISSHIKI Keiji
Department of Medicine, Shiga University of Medical Science
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Isshiki Keiji
Department Of Electrical Engineering School Of Science And Engineering Waseda University
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Yokomaku Yukiyo
Department Of Medicine Shiga University Of Medical Science
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Sugimoto Toshiro
Department Of Internal Medicine Shiga University Of Medical Science
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Kanasaki Keizo
Department Of Medicine Shiga University Of Medical Science
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Morita Yoshikata
Department Of Medicine Otsu Municipal Hospital
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KOYA Daisuke
Department of Internal Medicine, Shiga University of Medical Science, Otsu
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Kashiwagi Atsunori
Department of Internal Medicine, Shiga University of Medical Science
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Eguchi Yutaka
Critical and Intensive Care Medicine, Shiga University of Medical Science
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