Steroid-induced scleroderma renal crisis in an at-risk patient.
Scleroderma renal crisis (SRC) is a major complication of systemic sclerosis (SSc). We present a case of a patient who died of complications attributable to SRC in the context of recently diagnosed SSc. We review the typical clinical and laboratory features of SSc present in our patient and highlight those that identify greater risk of progression to SRC. Particular risk factors for SRC include cutaneous involvement, positive anti-RNA polymerase III antibodies and use of corticosteroids (CS). The authors emphasise the importance of risk evaluation when choosing to use CS in patients with SSc.
Royal Free Hospital, London, London, UK Department of Rheumatology, Chase Farm Hospital, Enfield, UK.
Sebastian Miguel
SM
Toescu
Royal Free Hospital, London, London, UK Department of Rheumatology, Chase Farm Hospital, Enfield, UK.
Alex
A
Mansell
Royal Free Hospital, London, London, UK.
Eoin
E
Dinneen
Department of Rheumatology, Chase Farm Hospital, Enfield, UK.
Malcolm
M
Persey
D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D004264:DNA Topoisomerases, Type I; D017809:Fatal Outcome; D005919:Glomerular Filtration Rate; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008297:Male; D009687:Nuclear Proteins / Q000276:immunology; D011239:Prednisolone / Q000009:adverse effects*; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications*
D000974:Antibodies, Antinuclear; D005938:Glucocorticoids; D009687:Nuclear Proteins; C048100:Scl 70 antigen, human; D011239:Prednisolone; D004264:DNA Topoisomerases, Type I