title: Normotensive scleroderma renal crisis with diffuse alveolar damage after corticosteroid therapy.
abstract: 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.
authors.affiliation: 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
authors.forename: Taio
authors.initials: T
authors.lastname: Naniwa
authors.forename: Shogo
authors.initials: S
authors.lastname: Banno
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takahashi
authors.forename: Shinji
authors.initials: S
authors.lastname: Maeda
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Hayami
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ueda