Cholesterol crystal embolization (CCE): Improvement of renal function with high-dose corticosteroid treatment.

Abstract

Cholesterol crystal embolization (CCE) is an important and often under-diagnosed cause of renal insufficiency in patients with atherosclerosis. So far, only statins are the mainstay of therapy and the role of corticosteroids is controversial. We describe a 57-year-old gentleman who presented with accelerated hypertension and renal failure three months after coronary angiogram. Renal biopsy showed cholesterol clefts in the arteriole. Initially, management with anti-hypertensives alone (already receiving statins since angiogram) was unsuccessful. A trial of high-dose corticosteroids resulted in an improvement of the general condition in the next two days, and the serum creatinine reduced gradually to 1.6 mg/dL over the next one month. In conclusion, high-dose corticosteroids are useful in the treatment of CCE associated renal failure, especially in cases with no spontaneous recovery of function.

• Authors: Madhav Desai, R Ram, Aruna Prayaga, K V Dakshinamurty
• Journal: Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (Saudi J Kidney Dis Transpl) Vol. 22 Issue 2 Pg. 327-30 (Mar 2011) ISSN: 1319-2442 [Print] Saudi Arabia
• PMID: 21422636 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Antihypertensive Agents
• Biomarkers
• Creatinine

Topics

• Adrenal Cortex Hormones (administration & dosage)
• Antihypertensive Agents (therapeutic use)
• Atherosclerosis (complications, drug therapy)
• Biomarkers (blood)
• Biopsy
• Coronary Angiography (adverse effects)
• Creatinine (blood)
• Embolism, Cholesterol (drug therapy, etiology, physiopathology)
• Humans
• Hypertension (complications, drug therapy)
• Kidney (drug effects, pathology, physiopathology)
• Male
• Middle Aged
• Renal Insufficiency (drug therapy, etiology, physiopathology)
• Treatment Outcome