title: A case of normotensive scleroderma renal crisis after high-dose methylprednisolone treatment.
abstract: A 68-year-old male was admitted for interstitial pneumonia associated with scleroderma. High-dose methylprednisolone was administered for treatment of the pneumonitis. Two weeks later, anemia, thrombocytopenia and progressive increase in BUN, creatinine and LDH were observed. Although the blood pressure remained normotensive, renal biopsy showed thrombosis of the polar arterioles and glomerular capillaries. The affected interlobular artery included concentric intimal thickening and thrombosis in the lumen. Our findings suggested that the antecedent use of high-dose corticosteroids is involved in precipitating normotensive renal crisis. Corticosteroids should be used in low doses and with great caution in scleroderma patients.
authors.affiliation: Department of Internal Medicine III, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kohno
authors.forename: T
authors.initials: T
authors.lastname: Katayama
authors.forename: K
authors.initials: K
authors.lastname: Majima
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.forename: S
authors.initials: S
authors.lastname: Iida
authors.forename: K
authors.initials: K
authors.lastname: Fukami
authors.forename: S
authors.initials: S
authors.lastname: Ueda
authors.forename: H
authors.initials: H
authors.lastname: Nishida
authors.forename: M
authors.initials: M
authors.lastname: Sata
authors.forename: S
authors.initials: S
authors.lastname: Kato
authors.forename: M
authors.initials: M
authors.lastname: Morimatsu
authors.forename: S
authors.initials: S
authors.lastname: Okuda
mesh_terms: D000368:Aged; D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000473:pathology; D001794:Blood Pressure; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000473:pathology; D012595:Scleroderma, Systemic / Q000150:complications*
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone