[Massive rhabdomyolysis: an uncommon complication of cholesterol embolization syndrome].

Abstract

A 79-year-old man with atherosclerosis presented blue toes and livedo reticularis. The patient had eroded aortic atheromatous plaques, and cholesterol embolization syndrome was suspected. An endovascular technique to exclude sources of cholesterol emboli was however performed. The patient immediately presented with severe muscle pain and total functional disability of lower limbs, new ischemic lesions of toes, anal and genital necrosis, and a livedo extended up to the abdomen. A massive rhabdomyolysis occurred associated with acute kidney injury and hyperkaliemia treated by continuous renal replacement therapy with regional citrate anticoagulation. Steroids have been introduced and renal function improved. Cholesterol crystals were also found on a skin biopsy, performed before endovascular procedure.

• Authors: J Mathieu, J-P Pertek, S Brua, Z Samia, M R Losser
• Journal: Annales francaises d'anesthesie et de reanimation (Ann Fr Anesth Reanim) Vol. 32 Issue 12 Pg. 879-81 (Dec 2013) ISSN: 1769-6623 [Electronic] France
• Vernacular Title: Rhabdomyolyse massive: une complication rare de la maladie des emboles de cholestérol.
• PMID: 24209502 (Publication Type: Case Reports, English Abstract, Journal Article)
• Copyright: Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Chemical References

• Anticoagulants
• Citrates
• Steroids

Topics

• Acute Kidney Injury (etiology, therapy)
• Aged
• Anticoagulants (therapeutic use)
• Atherosclerosis (complications)
• Biopsy
• Citrates (therapeutic use)
• Embolism, Cholesterol (complications, pathology)
• Embolization, Therapeutic
• Humans
• Hyperkalemia (etiology, therapy)
• Male
• Renal Replacement Therapy
• Rhabdomyolysis (etiology)
• Skin (pathology)
• Steroids (therapeutic use)