Progressive systemic sclerosis and postpartum renal failure complicated by peripheral gangrene

A patient with progressive systemic sclerosis (PSS) complicated by accelerated hypertension, postpartum renal failure and gangrene in all 4 extremities is presented. Pregnancy seldom has a significant effect upon the course of PSS unless there is renal involvement. Four previously reported cases of PSS with postpartum renal failure are reviewed. In our case, sepsis, shock, retained placenta, propranolol therapy and disseminated intravascular coagulation may have contributed to the development of renal failure and symmetrical peripheral gangrene.