Q: 58 year old male who underwent cardiac angiogram 3 weeks ago, now presented with acute renal failure. Another unexpected finding on blood workup is significant eosinophilia. On clincal exam following is noted but with good palpable pedal pulses. What is your diagnosis?
Answer: Cholesterol Emboli
Cholesterol embolism (CE) is occlusion of small- and medium-caliber arteries by cholesterol crystals. CE is often triggered by an invasive vascular procedure, administration of anticoagulants, local or systemic thrombolytic therapy, or trauma. These cause rupture of atheromatous plaques in proximal major arteries releasing cholesterol crystals into the bloodstream. The crystals migrate distally until they lodge in small arterioles, where they provoke an acute inflammatory response
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