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Mistaken identity: normotensive scleroderma renal crisis
Journal article   Open access   Peer reviewed

Mistaken identity: normotensive scleroderma renal crisis

Arwa Aburizik, Siddharth Singh, Laith Al-Rabadi and Christopher Blosser
BMJ case reports, Vol.2014(may29 1), pp.bcr2013202566-bcr2013202566
2014
DOI: 10.1136/bcr-2013-202566
PMCID: PMC4039838
PMID: 24876209
url
https://europepmc.org/articles/pmc4039838View
Published (Version of record) Open Access

Abstract

A patient presented with neuromuscular, respiratory and cardiac symptoms and was initially diagnosed with amyotrophic lateral sclerosis (ALS), myocardial ischaemia and pneumonia. He developed unexplained progressive kidney failure over the ensuing week, and his kidney biopsy showed thrombotic microangiopathy that led to the correct diagnosis of normotensive scleroderma renal crisis. His clinical presentation and course were consistent with systemic sclerosis and normotensive scleroderma renal crisis. He was treated with an ACE inhibitor (ACEi) and haemodialysis with significant functional improvement over the next 3 months to his prior baseline with the exception of kidney failure. This case highlights a diagnostic challenge requiring astute history and physical examination skills, and the value of a kidney biopsy in providing the final diagnosis.

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