Simon Raphaël, Berwert Lorenzo, Burnier Michel, Teta Daniel
Service de néphrologie et consultation d'hypertension, Département de médecine interne, CHUV, 1011 Lausanne.
Rev Med Suisse. 2010 Mar 3;6(238):432-4, 436-7.
Disseminated cholesterol crystal embolism is observed in elderly men with severe atherosclerosis. This syndrome may be triggered by arterial catheterizations, major vascular surgery, thrombolytic and/or anticoagulation treatment. Cutaneous signs, subacute renal insufficiency, a marked inflammatory syndrome and eosinophilia are common. Immunologic testing is normal except for hypocomplementaemia. The diagnosis may be confirmed by biopsy (skin, gastrointestinal or renal), and/or by a fundoscopic examination. The treatment consists in withdrawing all form of anticoagulation, proscribing vascular surgery and arterial catheterization, prescribing aspirin and statins, and controlling arterial blood pressure. Corticosteroids may be given in refractory cases. The prognosis of cholesterol crystal embolism is poor but may be improved by statins.
在患有严重动脉粥样硬化的老年男性中可观察到播散性胆固醇结晶栓塞。该综合征可能由动脉导管插入术、大型血管手术、溶栓和/或抗凝治疗引发。皮肤体征、亚急性肾功能不全、明显的炎症综合征和嗜酸性粒细胞增多很常见。除补体血症外，免疫检测正常。诊断可通过活检（皮肤、胃肠道或肾脏）和/或眼底检查来证实。治疗包括停用所有抗凝形式、禁止血管手术和动脉导管插入术、开具阿司匹林和他汀类药物以及控制动脉血压。在难治性病例中可给予皮质类固醇。胆固醇结晶栓塞的预后较差，但他汀类药物可能会改善预后。
