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Cholesterol Embolism Frequently Misdiagnosed

Better recognition of clinical characteristics is needed

FRIDAY, Nov. 10 (HealthDay News) -- Cholesterol embolism is a frequently misdiagnosed condition, according to a report published in the November issue of the Journal of the American Academy of Dermatology.

Anna Jucgla, M.D., of the University of Barcelona in Spain, and colleagues reviewed clinical records of 26 male patients with cholesterol embolism diagnosed clinically and by histopathology.

Only one of the subjects did not have pre-existing symptoms of atherosclerotic disease, and in 23 patients (88 percent) at least one precipitating factor was identified. Among the subjects, only nine patients (35 percent) were correctly diagnosed at admission, with the most common clinical findings being cutaneous lesions (88 percent) and renal failure (73 percent).

Twenty-one patients (81 percent) experienced complications such as dialysis, acute pulmonary edema, amputations or gastro-intestinal surgery, and the mortality rate was 58 percent (15 patients). The only factor associated with mortality was previous chronic renal failure.

"Cutaneous manifestations are commonly found but may be subtle and therefore must be looked for specifically. Recognition of cutaneous lesions by the dermatologist can help to make an early diagnosis, provide histologic confirmation with a skin biopsy and save the patient from inappropriate treatment," the authors conclude.

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