A case of renal crisis in a Korean scleroderma patient with anti-RNA polymerase I and III antibodies.
Scleroderma (SSc) renal crisis has been reported to be associated with anti-RNA polymerase I and III (RNAP I/III) antibodies in Caucasians and the Japanese. However, no report is available for Korean SSc patients. Here, we describe the case of a 65-yr-old female SSc patient who developed renal crisis and whose serum contained anti-RNAP I/III antibodies. She was finally diagnosed as having diffuse cutaneous SSc based on skin thickening proximal to the elbows and knees. Sudden hypertension, oliguria, and pulmonary edema were features of her renal crisis. Despite the use of captopril and adequate blood pressure control, her renal function deteriorated. Subsequent renal biopsy findings showed severe fibrinoid necrosis with luminal obliteration in interlobar arteries and arterioles consistent with SSc renal crisis. Serum anti-RNAP I/III antibodies were detected by radioimmunoprecipitation. This is the first report of a renal crisis in a Korean SSc patient with RNAP I/III antibodies.
Kang
Eun Ha
EH
Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Chongno-Gu, Seoul, Korea.
Im
Churl Hyun
CH
Kim
Su Ho
SH
Chung
Jae Rak
JR
Lee
Eun Young
EY
Kim
Dong Jo
DJ
Lee
Eun Bong
EB
Song
Yeong Wook
YW
D058186:Acute Kidney Injury / Q000150:complications* / Q000201:enzymology / Q000276:immunology*; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D003422:Critical Care; D005260:Female; D006801:Humans; D007723:Korea; D012318:RNA Polymerase I / Q000276:immunology*; D012320:RNA Polymerase III / Q000276:immunology*; D012595:Scleroderma, Systemic / Q000150:complications* / Q000201:enzymology / Q000276:immunology*
D001323:Autoantibodies; D012318:RNA Polymerase I; D012320:RNA Polymerase III