Polyneuropathy associated with cholesterol crystal embolism

Neurocrit Care. 2010 Feb;12(1):74-8. doi: 10.1007/s12028-009-9233-9. Epub 2009 Sep 23.


Introduction: Cholesterol crystal embolism complicating arterial catheterization usually presents as a multiorgan disease with renal failure, abdominal problems, and skin manifestations.

Methods: We present a patient with hypertension and generalized arteriosclerosis who presented with muscle weakness, diffuse pain in the extremities, and renal failure 3 weeks after coronary catheterization and angioplasty of the right coronary artery. Muscle weakness progressed during the following months.

Results: Nerve conduction studies and nerve biopsy showed severe axonal nerve injury. Biopsy of the kidney revealed the diagnosis of cholesterol crystal embolism.

Conclusion: The clinical presentation indicates a direct association of cholesterol crystal embolism and polyneuropathy. Although cholesterol crystal embolism represents a rare cause of polyneuropathy, it should be considered in patients with acute onset polyneuropathy and sudden onset multiorgan disease after arterial catheterization.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Aorta, Abdominal
  • Biopsy
  • Coronary Disease / therapy*
  • Diagnosis, Differential
  • Diffuse Axonal Injury / diagnosis
  • Diffuse Axonal Injury / etiology*
  • Diffuse Axonal Injury / pathology
  • Disease Progression
  • Embolism, Cholesterol / complications*
  • Humans
  • Ischemia / diagnosis
  • Ischemia / etiology
  • Ischemia / pathology
  • Kidney / blood supply
  • Male
  • Middle Aged
  • Neurologic Examination
  • Polyneuropathies / diagnosis
  • Polyneuropathies / etiology*
  • Polyneuropathies / pathology
  • Renal Artery / pathology
  • Renal Insufficiency / diagnosis
  • Renal Insufficiency / etiology
  • Renal Insufficiency / pathology
  • Sural Nerve / pathology