Small-vessel vasculitis associated with cholesterol embolism: a case report.

Area of Science:

• Vascular Medicine
• Rheumatology
• Dermatology

Background:

• Cholesterol embolism can lead to multi-organ dysfunction and immunological abnormalities.
• Vasculitis is an uncommon complication of cholesterol embolism, with few documented cases.

Purpose of the Study:

• To report a case of cholesterol embolism presenting with small-vessel vasculitis of the skin and muscles.
• To highlight the clinical, imaging, and histological findings in such a rare presentation.

Main Methods:

• Case presentation of an 82-year-old male with persistent fever, eosinophilia, and hypocomplementemia.
• Diagnostic workup included MRI of the thighs and skin/muscle biopsies.
• Treatment involved intravenous and oral glucocorticoids.

Main Results:

• The patient developed skin rash and myalgia, with MRI showing intramuscular hyperintensities.
• Histopathology confirmed small-vessel vasculitis and cholesterol embolism.
• Glucocorticoid therapy led to rapid improvement in muscle tenderness, but the patient later experienced mesenteric artery embolization and died.

Conclusions:

• Cholesterol embolism can be associated with small-vessel vasculitis affecting the skin and muscles.
• This case emphasizes the importance of considering vasculitis in patients with cholesterol embolism and relevant symptoms.