Blue toe syndrome treated with sympathectomy in a patient with acute renal failure caused by cholesterol embolization
Kidney Research and Clinical Practice
;
: 186-189, 2013.
Article
in English
| WPRIM
| ID: wpr-197120
ABSTRACT
Blue toe syndrome is the most frequent manifestation of tissue ischemia caused by cholesterol embolization (CE), which can lead to amputation of affected lower extremities, if severe. However, any effective treatment is lacking. We experienced a case of spontaneously presenting blue toe syndrome and concomitant acute renal failure in a patient with multiple atherosclerotic risk factors. CE was confirmed by renal biopsy. Despite medical treatment including prostaglandin therapy and narcotics, the toe lesion progressed to gangrene with worsening ischemic pain. Therefore, we performed lumbar sympathectomy, which provided dramatic pain relief as well as an adequate blood flow to the ischemic lower extremities, resulting in healing of the gangrenous lesion and avoiding toe amputation. This is the first reported case of a patient with intractable ischemic toe syndrome caused by CE that was treated successfully by sympathectomy. Our observations suggest that sympathectomy may be beneficial in some patients with CE-associated blue toe syndrome.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Sympathectomy
/
Biopsy
/
Toes
/
Cholesterol
/
Risk Factors
/
Embolism, Cholesterol
/
Blue Toe Syndrome
/
Lower Extremity
/
Acute Kidney Injury
/
Gangrene
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Kidney Research and Clinical Practice
Year:
2013
Type:
Article
Similar
MEDLINE
...
LILACS
LIS