Open AccessFat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma
Author(s) -
Nahoko Nishimura,
Shogo Banno,
Yukihiro Kimura,
Sayaka Maeda,
Mizuki Kobayashi,
Kumi Kawai,
Norihiro Suga,
Keisuke Suzuki,
Naoto Miura,
Toyoharu Yokoi,
Hirokazu Imai
Publication year - 2014
Publication title -
clinical medicine insights case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.187
H-Index - 12
ISSN - 1179-5476
DOI - 10.4137/ccrep.s12636
Subject(s) - medicine , fat embolism , disseminated intravascular coagulation , lactic acidosis , metabolic acidosis , pulmonary embolism , dialysis , ards , peritoneal dialysis , hypoxia (environmental) , autopsy , embolism , continuous ambulatory peritoneal dialysis , surgery , cardiology , lung , chemistry , organic chemistry , oxygen
A 66-year-old woman receiving continuous ambulatory peritoneal dialysis developed acute respiratory distress 12 hours after a fall. Blood gas analysis revealed hypoxia (PaO2 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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