Cholesterol embolic disease presenting as renal failure with acute pancreatitis

Renal failure and acute pancreatitis developed in a 63-year-old man after 2 angiography procedures and iliac artery surgery. The results of the renal biopsy showed no specific abnormalities and the cause of the pancreatitis could not be determined. The patient was treated with hemodialysis and conservative management for pancreatitis, however he died due to sepsis approximately 50 days after diagnosis. The autopsy revealed cholesterol crystals in several organs including the kidneys, pancreas, and spleen. Therefore, systemic cholesterol emboli may have contributed to the development of renal failure and acute pancreatitis in this case. Cholesterol crystals in the pancreas have frequently been observed at autopsy in patients with cholesterol emboli. The clinical development of acute pancreatitis, however, is quite rare in these cases. The present case is reported to increase awareness of the possible clinical presentations of systemic cholesterol embolic disease in an effort to increase the correct diagnosis of this condition.