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Clinical and Experimental Nephrology

, Volume 15, Issue 1, pp 159–163 | Cite as

Atheroembolic renal disease with rapid progression and fatal outcome

  • Bernardo FariaEmail author
  • Joana Vidinha
  • Cátia Pêgo
  • Jesus Garrido
  • Sérgio Lemos
  • Carla Lima
  • Giovanni Sorbo
  • Edgar Lorga Gomes
  • Teresa Carvalho
  • Paulo Loureiro
  • Tânia Sousa
Case Report

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.

Keywords

Atheroembolic Corticosteroids Hemodialysis Anticoagulation 

Notes

Conflict of interest

The authors declare that no conflict of interest exists.

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Copyright information

© Japanese Society of Nephrology 2010

Authors and Affiliations

  • Bernardo Faria
    • 1
    Email author
  • Joana Vidinha
    • 1
  • Cátia Pêgo
    • 1
  • Jesus Garrido
    • 1
  • Sérgio Lemos
    • 1
  • Carla Lima
    • 1
  • Giovanni Sorbo
    • 1
  • Edgar Lorga Gomes
    • 1
  • Teresa Carvalho
    • 2
  • Paulo Loureiro
    • 3
  • Tânia Sousa
    • 1
  1. 1.Nephrology and Dialysis UnitHospital São Teotónio-ViseuViseuPortugal
  2. 2.Department of PathologyHospital São Teotónio-ViseuViseuPortugal
  3. 3.Department of OphthalmologyHospital São Teotónio-ViseuViseuPortugal

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