Cheng DJ, Li L, Zheng XY, Tang SF. Idiopathic cholesterol crystal embolism with atheroembolic renal disease and blue toes syndrome: A case report. World J Clin Cases 2022; 10(25): 9162-9167 [PMID: 36157649 DOI: 10.12998/wjcc.v10.i25.9162]
Corresponding Author of This Article
Shui-Fu Tang, PhD, Academic Fellow, Division of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Jichang Road, Baiyun District, Guangzhou 510405, Guangdong Province, China. tsf0838@126.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2022; 10(25): 9162-9167 Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.9162
Idiopathic cholesterol crystal embolism with atheroembolic renal disease and blue toes syndrome: A case report
De-Jin Cheng, Lin Li, Xiang-Yue Zheng, Shui-Fu Tang
De-Jin Cheng, Shui-Fu Tang, Division of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Lin Li, Division of Nephrology, Hua Du Hospitals of Traditional Chinese and Western Medicine, Guangzhou 510800, Guangdong Province, China
Xiang-Yue Zheng, Division of Ophthalmology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Author contributions: Tang SF decided the patient’s treatment plan; Cheng DJ wrote the paper; and Li L and Zheng XY collected the clinical data.
Informed consent statement: The patient provided written informed consent.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors wrote the manuscript according to the requirements of the CARE Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shui-Fu Tang, PhD, Academic Fellow, Division of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Jichang Road, Baiyun District, Guangzhou 510405, Guangdong Province, China. tsf0838@126.com
Received: April 27, 2022 Peer-review started: April 27, 2022 First decision: June 16, 2022 Revised: June 28, 2022 Accepted: July 25, 2022 Article in press: July 25, 2022 Published online: September 6, 2022 Processing time: 121 Days and 7.6 Hours
Abstract
BACKGROUND
Cholesterol crystal embolization (CCE) is a multisystemic and fatal disease with multiple clinical manifestations; however, there are few cases of idiopathic CCE. Here we report a patient with idiopathic CCE accompanied by atheroembolic renal disease and blue toes who had a relatively good prognosis in the short-term due to early treatment with corticosteroids and statins.
CASE SUMMARY
A 76-year-old man complained of coldness, numbness and purple color change in his left foot for 7 d. He had a feeling of fatigue, constipation, foamy urine, poor appetite and sleep. He had a lacunar infarction for 5 years and hypertension for 9 mo. Laboratory results showed elevated eosinophils, cholesterol, uric acid, serum creatinine, urea and 24 h urine analysis revealed proteinuria. A renal biopsy revealed atheroembolic renal disease. Taken together, these findings strongly supported the diagnosis of idiopathic CCE and atheroembolic renal disease.
CONCLUSION
Atheroembolic renal disease and blue toes syndrome can be caused by idiopathic CCE, and early treatment with corticosteroids is effective but requires further investigation.
Core Tip: Idiopathic cholesterol crystal embolization can induce atheroembolic renal disease and blue toes syndrome, and the early corticosteroids treatment is effective.
