Cholesterol embolism:: an unusual cause of chronic iron deficiency anemia and insulin resistance

Background. - Cholesterol embolism disease (CED) is an extremely polymorphous clinical entity, Rare reports mention digestive or endocrine manifestations. Case report, - A 73 year-old female patient developed CED disclosed by iron deficiency anemia with chronic digestive bleeding associated with major insulin resistance. Discussion. - Solitary iron deficiency anemia as the inaugural sign of CED is exceptional. Rare reports in the Literature suggest it is related to polymorphous nonspecific lesions (ulcers, pseudotumoral lesions...) leading to chronic bleeding, Careful histopathology study of the lesions of fragments of healthy mucosa provides the correct diagnosis showing biconcave and optically empty slits. Insulin resistance has not been reported although prior diabetes is often mentioned as a predisposing factor for atherosclerosis, In our case, the role of CED was not determined, but pancreatic or inflammatory involvement can be envisaged.