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Pulmonary cholesterol crystal embolization

M S Sabatine1, D A Oelberg, E J Mark

  • 1Department of Medicine, Massachusetts General Hospital, Boston 02114, USA.

Chest
|December 24, 1997
PubMed
Summary
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Cholesterol crystal embolization (CCE) rarely affects the lungs, typically only with an aortocaval fistula. This report details the first case of lung CCE without a fistula, expanding its known presentations.

Area of Science:

  • Cardiovascular Medicine
  • Pulmonary Medicine
  • Nephrology

Background:

  • Cholesterol crystal embolization (CCE) is a known complication affecting multiple organ systems.
  • Lung involvement in CCE is rare and previously associated only with aortocaval fistulas.

Observation:

  • Presents the first pathologically confirmed case of CCE to the lung without an arteriovenous fistula.
  • Reviews precipitants, symptoms, signs, and laboratory findings associated with CCE.

Findings:

  • Common CCE symptoms include calf claudication, gastrointestinal bleeding, and weight loss.
  • Characteristic signs include livedo reticularis, gangrene, and ulcers, with laboratory findings of azotemia, proteinuria, anemia, and eosinophilia.
  • Pulmonary hemorrhage is identified as a presenting sign of CCE.

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Implications:

  • Pulmonary hemorrhage should be recognized as a potential manifestation of CCE.
  • CCE should be considered in the differential diagnosis of pulmonary-renal syndromes.