title: A case of early onset normotensive scleroderma renal crisis in a patient with diffuse cutaneous systemic sclerosis.
abstract: Scleroderma renal crisis (SRC) has classically been defined as a new onset of accelerated arterial hypertension associated with a rapid increase in serum creatinine concentration and/or microangiopathic hemolytic anemia. SRC occurs in approximately 20% of patients with systemic sclerosis who have diffuse cutaneous manifestations. In addition, 10% of reported cases of SRC with diffuse cutaneous involvement have normal blood pressures; in the majority of these cases, SRC occurs after treatment with corticosteroids. We describe a patient who presented with an early onset SRC in the setting of diffuse cutaneous systemic sclerosis in evolution without prior accelerated arterial hypertension or corticosteroid use.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21215, USA.
authors.forename: Hany G
authors.initials: HG
authors.lastname: Bashandy
authors.forename: Jason S
authors.initials: JS
authors.lastname: Javillo
authors.forename: Steven R
authors.initials: SR
authors.lastname: Gambert
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D012595:Scleroderma, Systemic / Q000150:complications* / Q000473:pathology; D012867:Skin / Q000473:pathology