1/10. cholesterol embolism in a patient with inflammatory abdominal aortic aneurysm.A 66-year-old man whose renal function had progressively deteriorated had an elevated blood pressure and also was found to have an inflammatory abdominal aortic aneurysm (AAA). Blood examination revealed that he had eosinophilia. livedo reticularis of the toes developed, and a skin biopsy specimen showed embolization of atheromatous plaques in the arterioles of the subcutaneous tissue. Progressive enlargement of inflammatory AAA may have dislodged the atheromatous plaques, resulting in cholesterol embolism.- - - - - - - - - - ranking = 1keywords = reticularis (Clic here for more details about this article) |
2/10. cholesterol crystal embolization causing acute renal failure.Acute renal failure due to cholesterol embolization is a complication of severe generalized arteriosclerotic disease. It occurs spontaneously, or more often, as a complication of major medical or surgical procedures such as angiography and vascular surgery. The demonstration of characteristic cholesterol crystals in tissue biopsy specimens is a pathognomonic finding. However, renal cholesterol embolism may be clinically diagnosed when renal failure develops after known inciting factors or together with systemic manifestations of atheromatous embolization such as lower extremity livedo reticularis and focal digital ischemia. We report two cases of acute renal failure in which cholesterol embolization was found in skin and renal biopsies. One patient's renal function stabilized, but not to the basal level and the other patient developed end-stage renal disease.- - - - - - - - - - ranking = 4.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
3/10. Catastrophic antiphospholipid syndrome: remission following leg amputation in 2 cases.OBJECTIVE: The antiphospholipid syndrome is characterized by venous and arterial thrombotic events that are often recurrent, thrombocytopenia, recurrent fetal loss, and elevated titers of antiphospholipid antibodies. A subtype of patients with a particularly overwhelming clinical picture has been termed catastrophic antiphospholipid syndrome (CAPS). In this report, we present 2 patients who exhibited a similar multisystem disorder associated with gangrenous changes in the lower extremities. methods: Two patients with CAPS are presented, highlighting the impact of this disorder on the patients and the response to various therapeutic modalities. RESULTS: Both patients had pulmonary, cardiac, cutaneous, and neurologic findings consistent with CAPS. In addition, they had large purulent leg ulcers associated with livedo reticularis. amputation of the legs in each case induced remission of the systemic illness. CONCLUSIONS: We believe that infection plays a significant role in the pathogenesis and amplification of the antiphospholipid syndrome. In certain patients, this association probably is mediated via immune mechanisms, which also enhance the genesis of atherosclerosis. After the foci of infection (suppurative leg ulcers) were removed, the underlying illness improved. These case studies provide an opportunity to study the interrelationship between several confounding factors that converge and lead to the development of this autoimmune condition.- - - - - - - - - - ranking = 4.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
4/10. cholesterol embolisation: a lethal complication of vascular catheterisation.cholesterol embolisation after vascular catheterisation occurred in 5 patients. It tended to be associated with difficult manipulation of the catheter within a severely diseased aorta, and a common feature is leg pain with livedo reticularis despite palpable pulses. confusion, renal failure, and death ultimately ensue.- - - - - - - - - - ranking = 4.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
5/10. cholesterol atheroembolic renal disease. Report of 3 cases with emphasis on diagnosis by skin biopsy and extended survival.Because antemortem diagnosis is difficult, renal failure due to cholesterol atheroembolism has, until recently, been regarded as a uniformly irreversible and generally fatal disease. Of late, recovery of renal function in several patients in whom the diagnosis was made by organ or other invasive biopsy has been reported. Three cases of cholesterol atheroembolic renal failure in which the diagnosis was made by simple, noninvasive biopsy of the skin in areas showing livedo reticularis are described. Two of the patients, including 1 who required dialysis for 2 months, had an extended survival with recovery of renal function.- - - - - - - - - - ranking = 4.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
6/10. livedo reticularis due to multiple cholesterol emboli.Three patients with advanced atherosclerotic vascular disease developed multiple cholesterol emboli. The clinical presentation typically includes livedo reticularis of the lower part of the body and purple toes. Small areas of necrosis and ulceration may be present distally, despite palpable pulses. Muscular and abdominal pain, as well as alterations in renal function, may also occur. Cutaneous biopsy reveals characteristic cholesterol clefts within atheromatous debris filling small, deep arterial lumen. Pathophysiologic mechanisms are discussed.- - - - - - - - - - ranking = 8.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
7/10. Multiple cholesterol emboli syndrome after angiography.Multiple cholesterol emboli syndrome (MCES) after angiography has been reported infrequently. Seven patients (from five reports) who developed MCES after angiography are reviewed. An eighth case is described. All patients had evidence of extensive atherosclerosis. Following angiography of the eight patients, six demonstrated livedo reticularis below the umbilicus; technical difficulties were reported in four; four became febrile and/or hypertensive; and only one survived. Since therapy has been unsuccessful, careful angiographic technique is essential to prevent this syndrome.- - - - - - - - - - ranking = 4.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
8/10. The vasculitis of atrophie blanche (livedoid vasculitis) and abdominal aortic pathology.Seven of forty-two patients with livedoid vasculitis whose cases were reviewed at the Mayo Clinic were found to have abdominal aortic disease, in the form of aortic calcification and atherosclerosis or aneurysm. None of these patients had any associated systemic mesenchymal disease (lupus erythematosus, periarteritis nodosa, rheumatoid arthritis, sjogren's syndrome, or carcinomatous diseases). Three patients received graft replacements for aneurysm or vascular occlusive disease. Removal of the aneurysm in one case was associated with resolution of the livedoid vasculitis. Abdominal aortic changes should be considered in patients with diagnosed livedoid vasculitis.- - - - - - - - - - ranking = 3.660333026163keywords = livedo (Clic here for more details about this article) |
9/10. Livedo racemosa: a report of five cases.We present 5 patients in whom the diagnosis of livedo racemosa gave rise to clinical and laboratory investigations revealing arterial disease of different etiologies. This presentation emphasizes the importance of not missing the clinical diagnosis of livedo racemosa.- - - - - - - - - - ranking = 1.0458094360466keywords = livedo (Clic here for more details about this article) |
10/10. pleural effusion in patients with systemic cholesterol embolization.We evaluated two patients with systemic cholesterol embolization (SCE) associated with the development of pleural effusions. These two patients had evidence of atherosclerosis and presented with livedo reticularis, renal insufficiency, and gangrenous cutaneous changes as manifestations of their SCE. In both cases, closed pleural biopsies demonstrated acute inflammation of the parietal pleura. Our experience with these individuals and a review of the medical literature suggest that pleural injury from atheromatous embolization may occur. physicians caring for patients with SCE should be aware of the possible association of pleural reactions with this process.- - - - - - - - - - ranking = 4.9962128769611keywords = livedo reticularis, reticularis, livedo (Clic here for more details about this article) |
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