title: Late recurrence of scleroderma renal crisis in a renal transplant recipient despite angiotensin II blockade.
abstract: Scleroderma renal crisis is the most severe renal manifestation of scleroderma and has been reported to recur rarely early after renal transplantation. Angiotensin II blockade is critical in preventing and treating scleroderma renal crisis, but some concern exists as to whether angiotensin II receptor blockers are clinically equivalent to angiotensin-converting enzyme inhibitors. The current case indicates that late recurrences of scleroderma renal crisis are possible in renal transplant recipients and that angiotensin-converting enzyme inhibitors, rather than angiotensin II receptor blockers, may be the superior drugs for such patients.
authors.affiliation: Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Winson Y
authors.initials: WY
authors.lastname: Cheung
authors.forename: Ian W
authors.initials: IW
authors.lastname: Gibson
authors.forename: David
authors.initials: D
authors.lastname: Rush
authors.forename: John
authors.initials: J
authors.lastname: Jeffery
authors.forename: Martin
authors.initials: M
authors.lastname: Karpinski
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001160:Arterioles / Q000473:pathology; D001485:Basement Membrane / Q000648:ultrastructure; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy / Q000209:etiology; D007165:Immunosuppression Therapy; D007674:Kidney Diseases / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D007678:Kidney Glomerulus / Q000473:pathology; D016030:Kidney Transplantation; D019808:Losartan / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology*; D017257:Ramipril / Q000627:therapeutic use; D012008:Recurrence; D012077:Renal Artery / Q000473:pathology; D045743:Scleroderma, Diffuse / Q000150:complications*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D019808:Losartan; D017257:Ramipril