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Abstract
L’association maladie des embolies de cholestérol et syndrome néphrotique est rare. Nous rapportons une observation d’embolie de cholestérol survenue chez un patient de 66 ans hospitalisé pour un syndrome néphrotique primitif cortico-résistant. Les manifestations cliniques, biologiques et paracliniques suggestives de maladie des embolies de cholestérol sont apparues 3 semaines après l’utilisation de bolus de corticoïdes 15mg/Kg/j pendant 3 jours.
L’aspect inhabituel de cette observation permet d’évoquer le caractère fortuit de cette association ou de recommander l’extrême prudence dans la prescription de fortes doses de corticoïdes chez les patients athéromateux.
ABSTRACTAssociation of cholesterol emboli and nephrotic syndrome is rare. We report a case of cholesterol embolism in a 66 year old patient with primary corticosteroid-resistant nephrotic syndrome. Clinical, biological and radiological manifestations suggestive of cholesterol embolism disease appeared 3 weeks after the use of corticosteroid boluses 15 mg / kg / day for 3 days. The unusual aspect of this observation makes it possible to evoke the fortuitous nature of this association.
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References
- MOOLENAAR W, LAMERS CBHW. Cholestérol Crystal emboisassions in Netherlands. A review of 842 cases field in the Ducth National. Pathology information system from 1973 through 1994. Arch Intern Med 1996; 156: 653-7
- FLORY C. Arterial occlusion produced by emboli from eroded aortic Athermatous plaques. Am J Pathol, 1995:21:954-9
- BELENFANT X, MEYRIER A, JACQUOT C. Supportive treatment improves survival in multiviscéral cholestérol crystal embolism AmJKidneyDis 1999; 33:840-50
- FINE M, KAPOOR W. Cholestérol crystal embolisation: a review of 221 cases in the English literature. Angiology, 1987; 38: 769-84
- SCOLARI F, TARDINICO R, ZANIR et al. Cholestérol crystal embolism: A recognizable cause of rénal disease. Am J kidney dis 2000; 36: 1089-1090.
- GRIMBERT R, AUDARD V, REMY P, LANG P, SAHALI D. Récent approach to the pathogenis of minimal change nephr tic syndrome Nephrol Dial transplant 2003, 18: 254-248.
- NAKAYAMA M, KATA FUCHI R, YANASE T et al. Steroid responsiveness and frequency of relapse in adult onset minimal change neph tic syndrome. Amj kidney Dis, 2002; 39: 503-512.
- CROSS SS. How common is cholestérol embolism? JclinPathol 1991; 44: 859-61.
- MEYRIER A. Cholestérol crystal embolism: Diagnosis and treatment. Kidney int 2006; 69: 1308-12.
- R. SIMON. Insuffisance rénale sévère sur maladie des emboles de cholestérol : controverses thérapeutiques révisitées. Rew Med Suisse 2010 ; 6 : 432-437
References
MOOLENAAR W, LAMERS CBHW. Cholestérol Crystal emboisassions in Netherlands. A review of 842 cases field in the Ducth National. Pathology information system from 1973 through 1994. Arch Intern Med 1996; 156: 653-7
FLORY C. Arterial occlusion produced by emboli from eroded aortic Athermatous plaques. Am J Pathol, 1995:21:954-9
BELENFANT X, MEYRIER A, JACQUOT C. Supportive treatment improves survival in multiviscéral cholestérol crystal embolism AmJKidneyDis 1999; 33:840-50
FINE M, KAPOOR W. Cholestérol crystal embolisation: a review of 221 cases in the English literature. Angiology, 1987; 38: 769-84
SCOLARI F, TARDINICO R, ZANIR et al. Cholestérol crystal embolism: A recognizable cause of rénal disease. Am J kidney dis 2000; 36: 1089-1090.
GRIMBERT R, AUDARD V, REMY P, LANG P, SAHALI D. Récent approach to the pathogenis of minimal change nephr tic syndrome Nephrol Dial transplant 2003, 18: 254-248.
NAKAYAMA M, KATA FUCHI R, YANASE T et al. Steroid responsiveness and frequency of relapse in adult onset minimal change neph tic syndrome. Amj kidney Dis, 2002; 39: 503-512.
CROSS SS. How common is cholestérol embolism? JclinPathol 1991; 44: 859-61.
MEYRIER A. Cholestérol crystal embolism: Diagnosis and treatment. Kidney int 2006; 69: 1308-12.
R. SIMON. Insuffisance rénale sévère sur maladie des emboles de cholestérol : controverses thérapeutiques révisitées. Rew Med Suisse 2010 ; 6 : 432-437