Reactions 1444 - 23 Mar 2013

SMethylprednisolone/prednisolone

Scleroderma renal crisis: case reportA 43-year-old woman developed scleroderma renal crisis

(SRC) following treatment with methylprednisolone andprednisolone [routes not stated].

The woman had lupus nephritis and systemic sclerosis(SSc)/systemic lupus erythematosus (SLE) overlap syndrome.She started receiving immunosuppressive therapy, whichconsisted of high-dose steroid and cyclophosphamide pulses.She received methylprednisolone 640mg for 3 days, followedby prednisolone 60mg [frequency not clearly stated]. She alsoreceived diuretics, amlodipine, vitamin D3 supplements andproton pump inhibitors. Her clinical course was favourable,but she developed SRC on day 15 of immunosuppressivetherapy. She had an elevated BP with haemolysis,thrombocytopenia and deteriorating kidney function.

The woman underwent haemodialysis and receivedperindopril. Her steroid doses were rapidly reduced, and bothher haemolysis and thrombocytopenia were corrected. Shewas weaned off dialysis, but she still had chronic renalinsufficiency.

Author comment: "[T]he use of high doses of[corticosteroids] has been associated with [SRC] in patient[s]with SSc. This report describes the occurrence of SRC in apatient with lupus nephritis and SSc/SLE overlap syndromewho was treated by [corticosteroids] and cyclophosphamide."Alayoud A, et al. Scleroderma renal crisis precipitated by steroid treatment insystemic lupus erythematosus and scleroderma overlap syndrome. Arab Journal ofNephrology and Transplantation 5: 153-157, No. 3, Sep 2012 -Morocco 803084601

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Reactions 23 Mar 2013 No. 14440114-9954/10/1444-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved