Normotensive renal failure in systemic sclerosis

Wiley - Tập 32 Số 9 - Trang 1128-1134 - 1989
David J. Helfrich1, Barbara F. Banner2, Virginia Steen2, Thomas A. Medsger3
1Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15261.
2Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
3985 Scaife Hall, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261

Tóm tắt

AbstractOf 140 patients with “scleroderma renal crisis” encountered during a 33‐year period, 15 of 131 (11%) whose blood pressures were recorded were normotensive during this complication. In comparison with 116 patients with hypertension, the normotensive patients significantly more often had microangiopathic hemolytic anemia (90% versus 38%) and thrombocytopenia (83% versus 21%). Pulmonary hemorrhage occurred in 6 normotensive patients. More normotensive patients had received high doses of corticosteroids (prednisone gE;30 mg/day) during the 2 months immediately preceding renal crisis (64% versus 16%). A role for corticosteroids in precipitating renal crisis is suggested. The 12‐month survival was significantly reduced in the normotensive patients (13% versus 35%).

Từ khóa


Tài liệu tham khảo

Auspitz H, Ein Beitrag zur Lehre vom Haut‐Sklerem der Erwachsenen, Wien Med Wochenschr, 13, 739

10.1016/S0140-6736(52)91798-4

10.1016/0002-9343(57)90324-8

10.7326/0003-4819-78-6-895

Johnson SJ, 1980, Development of scleroderma renal failure without severe hypertension: five cases (abstract), Arthritis Rheum, 23, 698

10.1109/MC.1979.1658533

10.1002/art.1780230510

10.1002/art.1780310207

Medsger TA, 1980, The natural history of skin involvement in progressive systemic sclerosis (abstract), Arthritis Rheum, 23, 720

10.1016/0002-9343(84)90986-0

10.1097/00000441-193903000-00006

10.1016/S0140-6736(56)91390-3

10.7326/0003-4819-52-3-517

10.1097/00005792-197401000-00001

10.1097/00005792-198311000-00001

10.1146/annurev.me.21.020170.001025

10.1038/ki.1975.36

10.1016/S0140-6736(69)92221-1

10.1001/archinte.1951.03810120084008

10.1001/jama.1951.02920340008003

Bagnall AW, 1954, The development of fatal “malignant” hypertension in a case of diffuse systemic sclerosis (scleroderma) in the course of treatment with adrenocorticotropin (abstract), Clin Res, 2, 145

Bartels ED, 1955, Renal affection complicating scleroderma, Acta Pathol Microbiol Scand, 150, 174

10.1056/NEJM195307092490201

Selye H, 1942, Production of nephrosclerosis by overdosage with desoxycorticosterone acetate, Can Med Assoc J, 47, 515

Hay EC, 1946, The assay of nephrosclerosis producing anterior pituitary preparations, Am J Physiol, 147, 299, 10.1152/ajplegacy.1946.147.2.299

10.1172/JCI113145

Baylis C, 1978, Mechanism of the glucocorticoid‐induced increase in glomerular filtration rate, Am J Physiol, 234, F166

10.1210/endo-52-3-245

10.1161/01.RES.31.1.44

10.1172/JCI112013

10.1172/JCI112528

Crutchley DJ, 1985, Glucocorticoid modulation of prostacyclin production in cultured bovine pulmonary endothelial cells, J Pharmacol Exp Ther, 233, 650

10.1210/endo-119-1-62

DeCaterina R, 1986, Modulation of arachidonic acid metabolism in human endothelial cells by glucocorticoids, Thromb Haemost, 55, 369, 10.1055/s-0038-1661566

10.1172/JCI110663

10.1007/BF01982624

Thông tin
Thông tin xuất bản

Wiley

Tập 32 Số 9

1128-1134

Thông tin tác giả