Cholesterol crystal embolization (CCE)‎ : improvement of renal function with high-dose corticosteroid treatment

Abstract EN

Cholesterol crystal embolization (CCE) is an important and often under-diagnosed cause of renal insufficiency in patients with atherosclerosis.

So far, only statins are the mainstay of therapy and the role of corticosteroids is controversial.

We describe a 57-year-old gentleman who presented with accelerated hypertension and renal failure three months after coronary angiogram.

Renal biopsy showed cholesterol clefts in the arteriole.

Initially, management with antihypertensive alone (already receiving statins since angiogram) was unsuccessful.

A trial of high dose corticosteroids resulted in an improvement of the general condition in the next two days, and the serum cretonne reduced gradually to 1.6 mg / dL over the next one month.

In conclusion, high dose corticosteroids are useful in the treatment of CCE associated renal failure, especially in cases with no spontaneous recovery of function.