Normotensive scleroderma renal crisis with diffuse alveolar damage after corticosteroid therapy.
A 68-year-old woman with systemic sclerosis developed acute respiratory failure due to diffuse alveolar hemorrhage and normotensive scleroderma renal crisis (SRC) shortly after the initiation of corticosteroid therapy. Treatment with angiotensin-converting enzyme inhibitor and plasmapheresis had failed in this patient. Autopsy showed diffuse alveolar damage and thrombotic micro-angiopathy. The sequence of events in this patient clarifies the pathologic process of normotensive SRC, and suggests a causative role of corticosteroid therapy and normotensive SRC.
Naniwa
Taio
T
Division of Rheumatology, Department of Internal Medicine and Molecular Science, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-ku, Nagoya, 467-8601, Japan. tnaniwa@med.nagoya-cu.ac.jp
Banno
Shogo
S
Takahashi
Nobuyuki
N
Maeda
Shinji
S
Hayami
Yoshihito
Y
Ueda
Ryuzo
R