Friday December 23, 2005
Scleroderma Renal Crisis (SRC)
Scleroderma Renal Crisis is one of the few rheumatological emergency where early diagnosis and treatment can make big difference in outcome. Wrong diagnosis may lead to wrong management pathway and eventually to very high mortality. SRC is heralded with hypertensive crisis associated with acute renal failure but the pearl is to avoid IV Labetolol or nitroprusside and gradually decrease blood pressure with PO angiotensin-converting enzyme (ACE) inhibitors. calcium channel blockers may help. Renal dialysis is a last resort. Another important differential diagnosis is from SLE (renal). 5 It has been suggested that use of steroids is associated with onset of scleroderma renal crisis.
See this precise review article on SRC here from Department of Rheumatology and Internal Diseases, Medical University in Białystok, Poland. (2005)
References: Click to get articles/abstract
1. What Is Scleroderma Renal Crisis and How Is it Managed? via medscape.com with free registration
2. Systemic Sclerosis With Renal Crisis and Pulmonary Hypertension - stanford.edu
3. Long-Term Outcomes of Scleroderma Renal Crisis - 17 October 2000 Volume 133 Issue 8 Pages 600-603 - annals
4. Scleroderma Renal Crisis: The Sword of Damocles. - JCR: J. of Clinical Rheum. 10(5):234-235, October 2004.
5. Rheumatologic Renal Disease: SLE vs. Scleroderma - ucsf.edu