Editorial

Scleroderma Renal Crisis: A High Index of Suspicion Speeds Diagnosis and Life-saving Treatment

Authors: Thomas A. Medsger, Jr, MD, Tatiana S. Rodriguez-Reyna, MD

Abstract

Scleroderma renal crisis (SRC) is a life-threatening visceral complication of systemic sclerosis (SSc) characterized by the abrupt onset of malignant hypertension and rapidly progressive, oliguric renal failure. Microangiopathic hemolytic anemia and thrombocytopenia are often found. Typical SRC patients have widespread (diffuse) skin thickening. Occasionally, however, the presentation is subtle, as illustrated by the case report of Bashandy et al1 in this issue of theJournal, delaying diagnosis and proper treatment. Therefore, a high index of suspicion is necessary when a patient with established SSc suddenly becomes ill.

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