著者
Satoshi Kumakura Takashi Nakamichi Nonoka Suzuki Shu Yamakage Ayako Ishikawa Emi Fujikura Satoko Sato Takeshi Aoki Hiroaki Musha Katsuko Kikuchi Tasuku Nagasawa Hiroshi Sato Sadayoshi Ito Mariko Miyazaki
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.2378-18, (Released:2019-02-01)
参考文献数
22
被引用文献数
4

A 66-year-old man was admitted to our hospital because of multiple refractory skin ulcers. Based on his severe systemic arterial calcification and severe calcium-phosphate imbalance due to severe kidney dysfunction, we initially considered calciphylaxis. However, a skin biopsy provided a diagnosis of cholesterol crystal embolization. Although we initiated hemodialysis, steroid treatment, and low-density lipoprotein-cholesterol apheresis, he died of multiple intestinal perforation. An autopsy showed cholesterol crystals occluding multiple organ arterioles. This case suggests that skin ulcers in patients with chronic kidney disease may be an important diagnostic hallmark and may be associated with several serious diseases.