Sarkar Rathindranath, Paul Rudrajit, Thakur Indranil, Chatterjee Sanjay, Singh Shyamaprasad
Professor and HOD, and Member, ICP Council, Medical College, Kolkata, West Bengal.
Associate Professor, Medical College, Kolkata, West Bengal.
J Assoc Physicians India. 2018 Aug;66(8):99-100.
Scleroderma is a connective tissue disease which may present with renal crisis. But sometimes, acute renal failure in scleroderma may be due to a second pathology. We here present a case of a 35 year old woman with systemic sclerosis, who presented with acute renal failure. She was started treatment as a case of scleroderma renal crisis. But her condition continued to deteriorate and she also developed some cutaneous vasculitic lesions. Her urine also had active sediments. Finally, serology and kidney biopsy established the renal lesion as stage IV lupus nephritis. She responded to immunosuppressive regimen for lupus with rapid improvement of kidney function. Such overlap of scleroderma with lupus is very rarely reported.
硬皮病是一种可能伴有肾危象的结缔组织病。但有时，硬皮病患者的急性肾衰竭可能是由第二种病理情况引起的。我们在此报告一例35岁患有系统性硬化症的女性，她出现了急性肾衰竭。她最初作为硬皮病肾危象病例开始接受治疗。但她的病情持续恶化，还出现了一些皮肤血管炎病变。她的尿液中也有活动性沉渣。最终，血清学检查和肾活检确定肾脏病变为IV期狼疮性肾炎。她对狼疮的免疫抑制治疗方案有反应，肾功能迅速改善。硬皮病与狼疮的这种重叠情况很少有报道。
