Author/Editor		Rott, Tomaž; Koselj, Mira; Kern, Izidor
Title		Cholesterol crystal embolism (ChE) - atheroembolism
Type		članek
Source		In: Štiblar-Martinčič D, Petrovič D, editors. Cardiovascular diseases. Proceedings of the 32nd memorial meeting devoted to professor Janez Plečnik, International symposium in memory of professor Rene Favaloro; 2001 Dec 6-8; Ljubljana. Ljubljana: Medical faculty,
Publication year		2001
Volume		str. 185-95
Language		eng
Abstract		Introduction. Cholesterol crystal embolism (ChE) is still underestimated pathologic condition. Spontaneous ChE is relatively uncommon, nevertheless the population at risk for it is expanding with population getting older. More important is increase in iatrogenic ChE due to treatment with some drugs and especially because of diverse diagnostic and therapeutic surgical procedures on great vessels. Patients. 18 patients with ChE, proven either by fundoscopy, by kidney, spleen, skin or mediastinal lymph node biopsy, or by autopsy, are presented in this report. Results. ChE was confirmed by fundoscopy in one patient, and histologically by biopsies in 7, and by autopsies in 10 patients. Among the latter, there were 8 patients with ChE, representing 5% of 160 consecutive autopsies ofthe people exceeding 60 years. ChE occurred spontaneously in 10 persons, in another 7 after instrumental procedures on great arteries, including recurrent ChE in transplanted and retransplanted kidney in the same patient. In 1 patient, pathogenesis was not clarified. Kidney was affected in 16 (89%) patients. Multiple organ involvement (kidney, pancreas, spleen, eyes, colon, adrenal gland, brain, cerebellum, lung, multiple mediastinal lymph nodes) was proved in 8 of 10 patients with spontaneous ChE, but only in 1 of 7 pts with iatrogenic ChE. Conclusions. The incidence of iatrogenic ChE is becoming very important, and is probably higher than it is actually diagnosed. With kidney most often affected, ChE has to be considered in any patient with renal function deterioration, especially after any procedures on great vessels. The finding of ChE in two consecutive renal transplants suggests that the probability of ChE and its recurrence in the renal allograft recipients is very substantial. There is no specific and effective treatment, therefore preventive measures are the most important.
Descriptors		EMBOLISM, CHOLESTEROL BIOPSY AUTOPSY