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Rheumatol Int ; 29(10): 1223-9, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19048256

RESUMO

Scleroderma renal crisis (SRC) is a complication of systemic sclerosis characterized by the sudden onset of accelerated arterial hypertension, followed by progressive renal failure. Rarely, patients with SRC may be normotensive on presentation. These patients have poorer prognosis and higher mortality rates than those with hypertensive SRC. This is partly explained by the insidious course of normotensive SRC leading to delayed diagnosis and treatment. Normotensive patients also seem to be less responsive to current treatment modalities. Since available data on etiology, pathogenesis, and risk factors of the disease are inadequate, no effective therapy has been established to date. We report a patient with diffuse cutaneous scleroderma who developed SRC during his hospitalization. The patient remained normotensive and had an insidious course until oliguria and signs of hypervolemia occurred. Etiology, pathogenesis, risk factors, diagnosis, treatment modalities and prognosis of normotensive SRC are also discussed through previously published reports.


Assuntos
Injúria Renal Aguda/diagnóstico , Hipertensão Renal/diagnóstico , Esclerodermia Difusa/diagnóstico , Escleroderma Sistêmico/diagnóstico , Injúria Renal Aguda/etiologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Pressão Sanguínea , Evolução Fatal , Humanos , Hipertensão Renal/etiologia , Hipertensão Renal/terapia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Diálise Renal , Esclerodermia Difusa/complicações , Esclerodermia Difusa/patologia , Escleroderma Sistêmico/complicações
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