title: Scleroderma renal crisis during intravenous cyclophosphamide pulse therapy for complicated interstitial lung disease was successfully treated with angiotensin converting enzyme inhibitor and plasma exchange.
abstract: Systemic sclerosis (SSc) is a multiorgan disorder involving the skin, heart, lungs, kidneys, and intestines. Progressive interstitial lung disease (ILD) is a serious complication in SSc patients, and cyclophosphamide (CYC) is the only recommended therapy for this condition;(1)) however, its clinical effectiveness is not sufficient. Scleroderma renal crisis (SRC) is a rare complication, characterized by acute renal failure and progressive hypertension. Angiotensin-converting-enzyme inhibitor (ACE-i) is a widely accepted therapy for SRC. We report an SSc patient with SRC and progressive ILD who underwent treatment with CYC and successful treatment with ACE-i and plasma exchange (PE). SRC and ILD are significant contributors to morbidity and mortality among SSc patients, and the therapy for these disorders is of great interest to rheumatologists. This study presents the possibility of favorable effects of PE for SSc-associated ILD and SRC.
authors: 1Department of Rheumatology and Allergy, Shimane Prefectural Central Hospital, Izumo, Japan.
authors: Norihiro
authors: N
authors: Nagamura
authors: Department of Nephrology, Shimane Prefectural Central Hospital, Izumo, Japan.
authors: Seikon
authors: S
authors: Kin
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors; D003520:Cyclophosphamide; D005260:Female; D006801:Humans; D006977:Hypertension, Renal; D007262:Infusions, Intravenous; D017563:Lung Diseases, Interstitial; D010951:Plasma Exchange; D012595:Scleroderma, Systemic
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D003520:Cyclophosphamide
keywords: interstitial lung disease; scleroderma renal crisis; systemic sclerosis; thrombotic microangiopathy; thrombotic thrombocytopenic purpura