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

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...

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Detalles Bibliográficos
Autores principales: Nishimura, Nahoko, Banno, Shogo, Kimura, Yukihiro, Maeda, Sayaka, Kobayashi, Mizuki, Kawai, Kumi, Suga, Norihiro, Suzuki, Keisuke, Miura, Naoto, Yokoi, Toyoharu, Imai, Hirokazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Libertas Academica 2014
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921132/
https://www.ncbi.nlm.nih.gov/pubmed/24526839
http://dx.doi.org/10.4137/CCRep.S12636
Descripción
Sumario: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.

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