Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma

Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma

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A 66-year-old woman receiving continuous ambulatory peritoneal dialysis developed acute respiratory distress 12 hours after a fall. Blood gas analysis revealed hypoxia (PaO 2 67.7 torr) and metabolic acidosis with an increased anion gap, consistent with lactic acidosis (lactate, 86.5 mg/dL; normal r...

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Main Authors: Nahoko Nishimura, Shogo Banno, Yukihiro Kimura, Sayaka Maeda, Mizuki Kobayashi, Kumi Kawai, Norihiro Suga, Keisuke Suzuki, Naoto Miura, Toyoharu Yokoi, Hirokazu Imai
Format: Article
Language:English
Published: SAGE Publishing 2014-01-01
Series:Clinical Medicine Insights: Case Reports
Online Access:https://doi.org/10.4137/CCRep.S12636
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spelling doaj-f64b92047f704b65910df5846f732f952020-11-25T03:31:08ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762014-01-01710.4137/CCRep.S12636Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic SclerodermaNahoko Nishimura0Shogo Banno1Yukihiro Kimura2Sayaka Maeda3Mizuki Kobayashi4Kumi Kawai5Norihiro Suga6Keisuke Suzuki7Naoto Miura8Toyoharu Yokoi9Hirokazu Imai10Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Department of Clinical Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Department of Clinical Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Department of Clinical Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.Division of Nephrology and Rheumatology, Department of Internal Medicine, University School of Medicine, Nagakute, Aichi, 480-1195, Japan.A 66-year-old woman receiving continuous ambulatory peritoneal dialysis developed acute respiratory distress 12 hours after a fall. Blood gas analysis revealed hypoxia (PaO 2 67.7 torr) and metabolic acidosis with an increased anion gap, consistent with lactic acidosis (lactate, 86.5 mg/dL; normal range, 4.0–16.0). Magnetic resonance imaging showed a lumbar vertebral body fracture. On the fourth hospital day, the patient died of multiorgan failure and disseminated intravascular coagulation. Postmortem studies revealed fat emboli in the systemic circulation, ie, fat embolism syndrome. Diagnosing fat embolism syndrome can be difficult in patients on dialysis or in those with collagen vascular or pulmonary diseases.https://doi.org/10.4137/CCRep.S12636
collection DOAJ
language English
format Article
sources DOAJ
author Nahoko Nishimura
Shogo Banno
Yukihiro Kimura
Sayaka Maeda
Mizuki Kobayashi
Kumi Kawai
Norihiro Suga
Keisuke Suzuki
Naoto Miura
Toyoharu Yokoi
Hirokazu Imai
spellingShingle Nahoko Nishimura
Shogo Banno
Yukihiro Kimura
Sayaka Maeda
Mizuki Kobayashi
Kumi Kawai
Norihiro Suga
Keisuke Suzuki
Naoto Miura
Toyoharu Yokoi
Hirokazu Imai
Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
Clinical Medicine Insights: Case Reports
author_facet Nahoko Nishimura
Shogo Banno
Yukihiro Kimura
Sayaka Maeda
Mizuki Kobayashi
Kumi Kawai
Norihiro Suga
Keisuke Suzuki
Naoto Miura
Toyoharu Yokoi
Hirokazu Imai
author_sort Nahoko Nishimura
title Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
title_short Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
title_full Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
title_fullStr Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
title_full_unstemmed Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
title_sort fat embolism syndrome: an autopsy-proven case involving a patient on dialysis and systemic scleroderma
publisher SAGE Publishing
series Clinical Medicine Insights: Case Reports
issn 1179-5476
publishDate 2014-01-01
description A 66-year-old woman receiving continuous ambulatory peritoneal dialysis developed acute respiratory distress 12 hours after a fall. Blood gas analysis revealed hypoxia (PaO 2 67.7 torr) and metabolic acidosis with an increased anion gap, consistent with lactic acidosis (lactate, 86.5 mg/dL; normal range, 4.0–16.0). Magnetic resonance imaging showed a lumbar vertebral body fracture. On the fourth hospital day, the patient died of multiorgan failure and disseminated intravascular coagulation. Postmortem studies revealed fat emboli in the systemic circulation, ie, fat embolism syndrome. Diagnosing fat embolism syndrome can be difficult in patients on dialysis or in those with collagen vascular or pulmonary diseases.
url https://doi.org/10.4137/CCRep.S12636
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