Bauwens F, Duprez D, Clement D L
University Hospital, Gent, Belgium.
Acta Cardiol. 1989;44(4):323-7.
A 72-years-old male patient is described who presented with relapsing, digital ulcers on both feet, accompanied by digital cyanosis ("purple toes"). All episodes occurred 5 months after starting coumarin treatment for chronic atrial fibrillation and low output failure. Massive mural thrombosis was discovered of the entire abdominal aorta. Because of the clinical picture, together with progressive renal failure and persistent eosinophilia, cholesterol embolization from an ulcerated atherosclerotic plaque within the mural thrombus was highly suspected. Besides the clinical presentation of our patient, the spectrum of cholesterol embolization is much wider. The role of coumarin therapy is still speculative. Numerous reports however, indicate a potential role in precipitating the syndrome. The only therapy available consists of removing the source whenever possible.
本文描述了一名72岁男性患者，其双脚出现复发性指端溃疡，并伴有指端发绀（“紫色趾头”）。所有发作均在开始使用香豆素治疗慢性心房颤动和低心排血量衰竭5个月后出现。发现整个腹主动脉有大量壁内血栓形成。鉴于临床表现，再加上进行性肾衰竭和持续性嗜酸性粒细胞增多，高度怀疑是壁内血栓中溃疡性动脉粥样硬化斑块的胆固醇栓塞所致。除了我们患者的临床表现外，胆固醇栓塞的范围要广泛得多。香豆素治疗的作用仍具有推测性。然而，众多报告表明其在引发该综合征方面可能发挥作用。唯一可行的治疗方法是尽可能去除病因。
