Leroy D, Michel M, Mandard J C, Elie H, Deschamps P
Ann Dermatol Venereol. 1981;108(8-9):665-73.
The case of a 72-year-old man with cutaneous cholesterol emboli in association with disseminated intravascular coagulation (D.I.C.) is described. Favouring the crystal cholesterol emboli hypothesis are the livedo reticularis and purpura in the lower extremities, palpable pulses, arterioles containing cholesterol clefts. Favouring the hypothesis of D.I.C. are the purpuric lesions on the ears and nose, acral cyanosis and haemorrhagic bullae on the hands, intravascular fibrinous thrombi, hemostatic abnormalities and the efficacy of heparin. Two pathogenic hypotheses are discussed: 1) "spontaneous" crystal cholesterol emboli have started a D.I.C. following the release of thromboplastic substances; 2) a D.I.C. with its secondary fibrinolysis has provoked a dissolution of the thrombosis which covered the atheromatous plaques and started cholesterol crystal emboli.
本文描述了一例72岁男性患者，患有皮肤胆固醇栓子并伴有弥散性血管内凝血（DIC）。支持晶体胆固醇栓子假说的依据包括下肢的网状青斑和紫癜、可触及的脉搏、含有胆固醇裂隙的小动脉。支持DIC假说的依据包括耳部和鼻部的紫癜性病变、手部的肢端发绀和出血性大疱、血管内纤维蛋白血栓、止血异常以及肝素的疗效。讨论了两种致病假说：1）“自发性”晶体胆固醇栓子在释放促凝血物质后引发了DIC；2）伴有继发性纤维蛋白溶解的DIC引发了覆盖动脉粥样硬化斑块的血栓溶解，并启动了胆固醇晶体栓子形成。
