Scleroderma renal crisis with overlap to dermatomyositis triggered by COVID-19 infection: a case report

A 46-year-old man was diagnosed with anti jo-1 antibody-positive dermatomyositis 11 years ago and had been treated with prednisolone and tacrolimus. In the present case, after contracting SARS-CoV-2 virus infection, his dyspnoea rapidly worsened, and he presented with renal and cardiac failure. Based on the biopsy results of the same area and anti-U1-RNP antibody positivity, he was diagnosed with systemic sclerosis and scleroderma renal crisis and required haemodialysis. A renal biopsy performed later showed tubular atrophy, intratubular cell debris, and endothelial cell damage, consistent with scleroderma renal crisis. Although rapid skin hardening and high-dose glucocorticoid use are known risks for scleroderma renal crisis, scleroderma renal crisis triggered by novel SARS-CoV-2 virus infection has never been reported before and is very rare. It is crucial to identify the relationship between the scleroderma renal crisis and SARS-CoV-2 virus infection. This relationship can be explained through the RAS system, which is believed to play a role in the development of both.