Recurrent acute scleroderma renal crisis complicated by thrombotic thrombocytopenic purpura.
Acute renal crisis as an early manifestation of scleroderma is underemphasized, and its recurrence after initial successful therapy is rare. We describe a 32-year-old woman who presented with scleroderma renal crisis. A second episode of apparent renal crisis, however, was complicated by thrombotic thrombocytopenic purpura, which led to pancreatitis, a large cerebral infarction, and fatal outcome despite intensive therapy. This case illustrates the complexity and severity of diffuse systemic sclerosis presenting with multiple, major organ complications.
Kapur
A
A
Department of Internal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Ballou
S P
SP
Renston
J P
JP
Luna
E
E
Chung-Park
M
M
D000208:Acute Disease; D000328:Adult; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D009206:Myocardium / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology; D011697:Purpura, Thrombotic Thrombocytopenic / Q000209:etiology*; D012008:Recurrence; D012077:Renal Artery / Q000473:pathology; D012595:Scleroderma, Systemic / Q000150:complications* / Q000473:pathology; D014057:Tomography, X-Ray Computed