临床医学杂志图片刊载了一名79岁男性因血清肌酐结果4.0mg/dl入院。既往缺血性心肌病和慢性肾病（基线血清肌酐1.6mg/dl），一个月前行经导管主动脉瓣置换术。体格检查双脚青紫，其他实验室检测：白细胞总计数/μL且嗜酸性粒细胞百分比15％。经导管主动脉瓣置换术前，CTA示主动脉弥漫性动脉粥样硬化伴复杂斑块。本次入院肾脏活检结果：动脉和肾小球多发性针状裂隙，证实为胆固醇晶体栓塞。该予以糖皮质激素治疗，并继续服用阿司匹林和他汀类药物。血液透析尚未开始，肾功能逐渐改善。出院后半年随访，患者血清肌酐2.2mg/dl。

Ourimageinclinicalmedicinefeaturesa79-year-oldmanwhowasadmittedtothehospitalafterlaboratorytestsshowedaserumcreatininelevelof4.0mgperdeciliter.Hehadahistoryofischemiccardiomyopathyandhadchronickidneydisease(withabaselineserumcreatininelevelof1.6mgperdeciliter),andhehadundergonetranscatheteraortic-valvereplacement1monthearlier.Physicalexaminationshowedcyanosisofbothfeet.Additionallaboratorytestsshowedatotalwhite-cellcountofpermicroliterwith15%eosinophils.CTangiographythathadbeenperformedbeforetranscatheteraortic-valvereplacementshoweddiffuseatheromaintheaorta,withevidenceof

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