Diffused Alveolar Hemorrhage in the Setting of Scleroderma Renal Crisis

Systemic sclerosis (SS) is a chronic, connective tissue disorder that can affect the skin, subcutaneous tissues, and internal organs. There are two different categories of SS, limited cutaneous systemic sclerosis (LCSS) and diffuse cutaneous systemic sclerosis (DCSS). One of the most fearful situations faced in DCSS is scleroderma renal crisis (SRC). This is a rare but potentially life-threatening complication characterized by an acute, usually symptomatic, increase in blood pressure, rise in serum creatinine levels, oliguria, and thrombotic microangiopathic changes. Pulmonary involvement in the setting of SCR is an even more rare combination and usually can progress into acute hypoxic respiratory failure and lead to worse outcomes. We present herein a case of scleroderma renal crisis complicated with diffuse pulmonary hemorrhage.