Is atheroembolic disease a new differential diagnosis of pulmonary-renal syndrome?

Pulmonary involvement observed during atheroem- catheter was inserted. bolic disease is usually due to congestive heart failure Ten days after admission the patient became dysand not to pulmonary cholesterol crystal emboli. Very pnoeic. He was able to lie flat and had no peripheral few cases of biopsy-proven specific pulmonary involve- oedema, fever, sweats, chills, or cough. Inspiratory ment have previously been reported in the course of crackles were heard over the lower one-third of both atheroembolic disease [3,4]. We describe a case of lungs. Echocardiography was normal. Arterial-blood atheroembolic disease associated with endogenous gases were the following while breathing oxygen at 6 lipoid pneumonia. Because spumous macrophages are litres per minute: partial pressure of oxygen, 8 kPa; observed in the inflammatory reaction surrounding partial pressure of dioxide 4.5 kPa; pH 7.35. A radiocholesterol crystal clefts in diVerent sites, we hypothet- graph of the chest showed bilateral infiltrates more ize that their presence in brochoalveolar fluid may prominent in right mid- and lower lung fields. reflect the presence of cholesterol crystal emboli in the Computed tomography revealed extensive bilateral pulmonary parenchyma. infiltrates. Flexible fibreoptic bronchoscopy examination did not reveal endobronchial lesion. A bronchoalveolar lavage was performed. Bronchoalveolar fluid