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Iatrogenic scleroderma renal crisis:A case report and mini literature review for renal crisis

Discussion of Clinical Cases 2021年第3期8卷 4-8页

作者： Gülsah Boz Samet Karahan Nurdan Yüksek Kayseri City Education and Research Hospital Department of Internal MedicineDivision of NephrologyKayseriTurkey Kayseri City Education and Research Hospital Department of Internal MedicineDivision of RheumatologyKayseriTurkey Kayseri City Education and Research Hospital Department of Internal MedicineKayseriTurkey

Background:Systemic sclerosis is a connective tissue disease characterized by fibrosis of the skin and organs,marked changes in microvascular structure,cellular and humoral immune *** involvement is more frequent and mainly characterized by moderate proteinuria,elevated serum creatinine levels,and *** most common kidney involvement in SSc is scleroderma renal crisis(SRC)that is fatal without prompt *** report:A 52-year-old Caucasian male with known diffuse cutaneous systemic sclerosis was hospitalized with communityacquired *** the fifth day after appropriate antibiotic therapy and 60 mg/day methylprednisolone,decreased urine output,arterial hypertension,decreased renal function and pulmonary edema *** patient was diagnosed with a scleroderma renal *** hemodialysis was applied to the patient,and captopril 6×25 mg/day and nifedipine 2*60 mg/day treatment were *** received a routine hemodialysis program for about three *** hemodialysis program was terminated when the patient’s urine quality and quantity ***:SRC,characterized by malignant hypertension,azotemia,microangiopathic hemolytic anemia,and kidney failure,is one of the most important complications of systemic sclerosis with a poor prognosis without prompt *** use is one of the important risk factors that precipitate SRC *** angiotensin-converting enzyme inhibitors,survival increased after SRC,the need for dialysis decreased,and usually allowed the discontinuation of dialysis treatment within about 6-18 *** of SRC in the presence of the above-mentioned findings in patients with a diagnosis or suspected systemic sclerosis can be considered the most important treatment step.

关键词： scleroderma Systemic sclerosis scleroderma renal crisis Systemic sclerosis-associated thrombotic microangiopathy

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Journey of a patient with scleroderma from renal failure up to kidney transplantation

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World Journal of Transplantation 2021年第9期11卷 372-387页

作者： Fedaey Abbas Mohsen El Kossi Ihab Sakr Shaheen Ajay Sharma Ahmed Halawa Department of Nephrology Faculty of Health and ScienceUniversity of LiverpoolInstitute of Learning and TeachingSchool of MedicineLiverpool L693GBUnited Kingdom Doncaster renal Unit Doncaster Royal InfirmaryDoncaster DN25LTUnited Kingdom Department of Paediatric Nephrology St James’s University HospitalGlasgow G514TFUnited Kingdom Department of Transplant Surgery Royal Liverpool University HospitalLiverpool L78XPUnited Kingdom Department of Transplant Surgery Sheffield Teaching HospitalSheffield S57AUUnited Kingdom

The increased awareness of systemic sclerosis(SS)and its pathogenetic background made the management of this disease more amenable than previously ***,scleroderma renal crisis(SRC)is a rarely seen as an associated disorder that may involve 2%-15%of SS *** presented with earlier,rapidly progressing,diffuse cutaneous SS disease,mostly in the first 3-5 years after non-Raynaud clinical manifestations,are more vulnerable to develop *** comprises a collection of acute,mostly symptomatic rise in blood pressure,elevation in serum creatinine concentrations,oliguria and thrombotic microangiopathy in almost 50%of *** advent of the antihypertensive angiotensin converting enzyme inhibitors in 1980 was associated with significant improvement in SRC *** a scleroderma patient maintained on regular dialysis;every effort should be exerted to declare any possible evidence of renal recovery.A given period of almost two years has been suggested prior to proceeding in a kidney transplant(KTx).Of note,SS patients on dialysis have the highest opportunity of renal recovery and withdrawal from dialysis as compared to other causes of end-stage renal disease(ESRD).KTx that is the best well-known therapeutic option for ESRD patients can also be offered to SS *** to other primary renal diseases,SS-related ESRD was considered for a long period of poor patient and allograft *** involvement in an SS patient is considered a strong post-transplant independent risk factor of *** of SRC after transplantation has been observed in some ***,an excellent post-transplant patient and graft outcome have been recently ***,the absence of extrarenal manifestations in an SS-induced ESRD patient can be accepted as a robust indicator for a successful KTx.

关键词： Systemic sclerosis scleroderma renal crisis Risk factors renal failure Hemodialysis Kidney transplant

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