Multiple cholesterol emboli syndrome simulating systemic necrotizing vasculitis

The multiple cholesterol emboli syndrome associated with severe atherosclerotic vascular disease may clinically simulate systemic necrotizing vasculitis. Widespread visceral infarctions in conjunction with potential leukocytosis, eosinophilia, thrombocytopenia, hypocomplementemia and an elevated sedimentation rate may be present. It frequently occurs after intraarterial procedures such as cardiac catheterization and aortography. Diagnosis is made by biopsy of involved tissue. It is essential to establish a proper diagnosis to avoid inappropriate use of steroid and cytotoxic treatment measures.