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Normotensive renal failure in systemic sclerosis.

D J Helfrich1, B Banner, V D Steen

  • 1Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15261.

Arthritis and Rheumatism
|September 1, 1989
PubMed
Summary
This summary is machine-generated.

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Scleroderma renal crisis can occur in normotensive patients, who exhibit distinct clinical features and poorer survival. High-dose corticosteroids may precipitate this complication, warranting further investigation.

Area of Science:

  • Nephrology
  • Rheumatology
  • Hematology

Background:

  • Scleroderma renal crisis (SRC) is a serious complication of systemic sclerosis.
  • While hypertension is a hallmark of SRC, normotensive cases have been reported.

Purpose of the Study:

  • To characterize the clinical features, outcomes, and potential triggers of SRC in normotensive patients.
  • To compare normotensive SRC patients with their hypertensive counterparts.

Main Methods:

  • Retrospective analysis of 140 patients with SRC over 33 years.
  • Comparison of clinical data between normotensive (n=15) and hypertensive (n=116) SRC patients.
  • Analysis of preceding corticosteroid use.

Main Results:

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  • 11% of SRC patients were normotensive.
  • Normotensive SRC patients had higher rates of microangiopathic hemolytic anemia (90% vs. 38%) and thrombocytopenia (83% vs. 21%).
  • Pulmonary hemorrhage occurred in 6 normotensive patients.
  • Higher corticosteroid use (≥30 mg/day prednisone) preceded SRC in normotensive patients (64% vs. 16%).
  • 12-month survival was significantly lower in normotensive SRC patients (13% vs. 35%).

    • Conclusions:

    • Normotensive SRC presents with distinct hematologic complications and worse prognosis.
    • High-dose corticosteroid use may be a precipitating factor for SRC in normotensive individuals.
    • Further research is needed to elucidate the role of corticosteroids in SRC pathogenesis.