Lesson of the month 1: sudden onset postural livedo reticularis, cyanotic toes and multiorgan failure

Clin Med (Lond). 2014 Jun;14(3):314-5. doi: 10.7861/clinmedicine.14-3-314.


Cholesterol embolisation syndrome (CES) is a rare but serious disease with high mortality caused by the formation of an embolus made up of cholesterol crystals from atherosclerotic plaques. Its clinical presentation is usually initially insidious and it often remains unrecognised because of its non-specific clinical presentation, which can cause delays in treatment and high mortality. The most common physical symptoms are cutaneous. We present a lethal case of CES to increase the awareness about this serious condition.

Keywords: Atherosclerotic plaque; cyanosis; embolism; livedo reticularis; multiorgan failure.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cyanosis / pathology
  • Fatal Outcome
  • Foot / pathology
  • Humans
  • Leg / pathology
  • Livedo Reticularis / diagnosis*
  • Livedo Reticularis / pathology
  • Male
  • Multiple Organ Failure / pathology