title: Recurrent acute scleroderma renal crisis complicated by thrombotic thrombocytopenic purpura.
abstract: 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.
authors.affiliation: Department of Internal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: A
authors.initials: A
authors.lastname: Kapur
authors.forename: S P
authors.initials: SP
authors.lastname: Ballou
authors.forename: J P
authors.initials: JP
authors.lastname: Renston
authors.forename: E
authors.initials: E
authors.lastname: Luna
authors.forename: M
authors.initials: M
authors.lastname: Chung-Park
mesh_terms: 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