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Nephrol Dial Transplant (2002) 17: 156-158
© 2002 European Renal Association-European Dialysis and Transplant Association

Interesting Case

Which type of dialysis in patients with cholesterol crystal embolism?

Gaëlle Gillerot1, Christine Sempoux2, Yves Pirson1 and Olivier Devuyst1,

1 Divisions of Nephrology and 2 Pathology, Saint Luc Academic Hospital, Université Catholique de Louvain, Brussels, Belgium

Keywords: anticoagulation; cholesterol crystal; eosinophilia; haemodialysis; peritoneal dialysis

Introduction

Cholesterol crystal embolism (CCE) is an increasingly frequent and potentially severe complication of atherosclerotic vascular disease, resulting from embolization of cholesterol crystals from aortic atherosclerotic plaques to various organs. As recently reviewed [1], CCE may occur spontaneously but is usually triggered by a variety of procedures including arteriography, vascular surgery and anticoagulation—resulting from administration of heparin, low-molecular-weight heparin, oral anticoagulants or thrombolysis [1–3]. The diagnosis of CEE may be challenging because both the clinical picture, which ranges from totally asymptomatic to multisystemic disease, and the laboratory findings lack specificity [1]. Diagnostic clues include risk factors for atherosclerosis, characteristic features such as renal, retinal or cutaneous involvement, and laboratory abnormalities such as hypereosinophilia and hypocomplementaemia [1]. In absence of clinical evidence, histological identification of cholesterol crystals in a target organ remains essential for diagnosis and is the only way to distinguish . . . [Full Text of this Article]

Case

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