<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662019000300441</article-id>
<article-id pub-id-type="doi">10.24245/mim.v35i3.2324</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Embolismo por cristales de colesterol con síndrome de disfunción multiorgánica]]></article-title>
<article-title xml:lang="en"><![CDATA[Cholesterol crystal embolism with multiorgan dysfunction syndrome]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cernadas]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Perosi]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Capria]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campos]]></surname>
<given-names><![CDATA[Liliana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Spina]]></surname>
<given-names><![CDATA[Salvador]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lago]]></surname>
<given-names><![CDATA[Nestor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mugnolo]]></surname>
<given-names><![CDATA[Roberto J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Aeronáutico Central Departamento de Clínica Médica ]]></institution>
<addr-line><![CDATA[CABA ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Aeronáutico Central Departamento de Clínica Médica ]]></institution>
<addr-line><![CDATA[CABA ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Aeronáutico Central Departamento de Clínica Médica ]]></institution>
<addr-line><![CDATA[CABA ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Aeronáutico Central Departamento de Clínica Médica ]]></institution>
<addr-line><![CDATA[CABA ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Aeronáutico Central Departamento de Patología ]]></institution>
<addr-line><![CDATA[CABA ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Aeronáutico Central Departamento de Clínica Médica ]]></institution>
<addr-line><![CDATA[CABA ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>35</volume>
<numero>3</numero>
<fpage>441</fpage>
<lpage>447</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662019000300441&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662019000300441&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662019000300441&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La embolia por cristales de colesterol es una enfermedad sistémica caracterizada por la oclusión de pequeñas arterias debido al desprendimiento de los mismos desde las placas de ateroma formadas en las paredes de arterias principales. Este caso clínico corresponde a un paciente masculino de 77 años de edad con factores de riesgo de enfermedad vascular que ingresó al servicio de urgencias por disnea y ortopnea. Se diagnosticó un cuadro clínico de insuficiencia cardiaca aguda y recibió tratamiento médico con buena respuesta. Se realizó una cinecoronariografía que evidenció severa ateroesclerosis coronaria con enfermedad de tres vasos, recibió tratamiento endovascular con colocación de endoprótesis vasculares. Luego de 20 días el paciente evolucionó con deposiciones melénicas, oligoanuria y claudicación intermitente progresiva en ambos miembros inferiores. Se observó obstrucción del flujo arterial en ambas arterias pedias por ecografía doppler; las biopsias de la piel de los pies revelaron signos vasculares correspondientes a depósitos de cristales de colesterol. Se interpretó enfermedad por embolia de cristales de colesterol secundario a las maniobras de cateterización previa, que provocaron alteraciones multiorgánicas isquémicas y persistentes. Resulta interesante este padecimiento porque es un proceso grave que demanda alto grado de sospecha clínica, el diagnóstico definitivo se establece mediante biopsia de las lesiones cutáneas, el pronóstico depende de la extensión de la enfermedad y en la actualidad no existe un tratamiento específico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: The cholesterol crystal embolism is a systemic disease characterized by the occlusion of small arteries due these crystals, which come from the atheroma plaques of the walls of major arteries. This clinical case corresponds to a 77-year-old male patient with risk factors for cardiovascular disease who entered at the emergency service due dyspnea and orthopnea. In the Coronary Unit, a clinical status of acute heart failure was diagnosed, receiving medical treatment with good response. It was decided to perform a coronary angiography which showed a severe coronary atherosclerosis with 3-vessel compromised and endovascular treatment was performed with stent placement. After 20 days, the patient evolved with melenic depositions oligoanuria and progressive intermittent claudication in both lower limbs. Obstruction of arterial flow was observed in both pedia arteries by doppler ultrasound. Skin biopsies of lower limbs revealed vascular signs of deposits of cholesterol crystals. It was recognized as a cholesterol crystal disease secondary to previous medical catheterization procedures, causing ischemia and persistent alterations in the digestive and renal systems as well as in the skin of the lower limbs. This is an important affection because it is a serious process that demands a high level of clinical suspicion, the definitive diagnosis is established through the biopsy of the cutaneous lesions and the prognosis depends on the extension of the disease. Nowadays, there is no specific medical treatment of this disease.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Embolia por colesterol]]></kwd>
<kwd lng="es"><![CDATA[ateroesclerosis]]></kwd>
<kwd lng="es"><![CDATA[enfermedad vascular]]></kwd>
<kwd lng="en"><![CDATA[Embolism, cholesterol]]></kwd>
<kwd lng="en"><![CDATA[Atherosclerosis]]></kwd>
<kwd lng="en"><![CDATA[Vascular diseases]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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